Hyperhidrosis is a condition characterized by excessive and unpredictable sweating that exceeds what is necessary for the regulation of body temperature. This condition frequently impacts the hands, feet, armpits, and facial regions, thereby interfering with daily activities and sometimes result in significant embarrassment for affected individuals. Treatment modalities for hyperhidrosis are diverse, encompassing strong antiperspirants designed to manage mild to moderate sweating, as well as oral pharmacological agents aimed at regulating overactive sweat glands. In instances of severe hyperhidrosis, patients might explore advanced therapeutic options, including Botox injections that provide temporary inhibition of the nerves responsible for sweating.
At Ali’i Nani Aesthetic Medicine, we offer Double Defense Against Sweat & Smell using laser and Botox injections. This bundled treatment combines FDA-approved Botox intradermal injection in the underarm to reduce hyperhidrosis while Nd:YAG laser thermally disrupt odor-producing glands. For best results, we recommend maintenance Botox and laser treatment every 4–9 months.
Botox targets the eccrine glands which helps reduce underarm sweating. Laser targets the apocrine glands which helps with odor.
| Feature | Eccrine Glands | Apocrine Glands |
|---|---|---|
| Where they are | Found all over the body, especially palms, soles, forehead, underarms. | Concentrated in underarms, groin, around nipples, scalp. |
| What they do | Produce clear, watery sweat mostly for cooling the body (thermoregulation). | Produce thicker, milky fluid — not for cooling but activated by stress or hormones. |
| When active | Active from birth; respond mainly to heat, exercise, stress. | Become active at puberty; respond to emotional stress, sexual arousal. |
| What triggers them | Heat, physical activity, body temperature rise. | Emotional triggers (fear, anxiety, excitement), hormonal signals. |
| Smell factor | Eccrine sweat is odorless (mostly water + salt); odor comes if bacteria break it down. | Apocrine sweat contains proteins + lipids that bacteria easily break down → causes body odor. |
| Relevance for treatment | Botox blocks eccrine sweat by stopping nerve signals → controls sweating. | Laser or energy-based treatments can reduce apocrine gland activity → reduces odor. |
Before your treatment:
(1) Shave underarm hair one or two days before your appointment
(2) Wear comfortable shirt (sleeveless/ tank top if you have) for better assessment and administration of treatments
(3) Avoid applying deodorant, antiperspirant, perfumes, or lotions on the day of treatmen
(4) Ensure that you don’t have active skin infections, rashes, or open wounds in underarm area
(5) Ensure that you are not pregnant or breastfeeding
(6) Ensure that you have no recent waxing, exfoliation, or harsh scrubbing of the underarms.
During your treatment:
(1) We will go over your concerns and pertinent medical history that may influence treatment response
(2) Prep the area, laser first
(3) Cool down for 5-10 mins
(4) Botox injection
After your treatment:
(1) Avoid deodorants/antiperspirants for 24–48 hours.
(2) No vigorous exercise or excessive sweating for 24–48 hours.
(3) No heat exposure (sauna, hot tubs, long hot showers) for 24–48 hours.
(4) No underarm shaving or harsh exfoliation for ~3 days.
(5) Use gentle cleansers; avoid perfumes or alcohol-based products on the area.
(6) Minor swelling, redness, or small bruises can last 1–3 days; apply cool packs if needed (don’t apply ice directly on skin).
(7) Botox effects will start in ~3–7 days, with max results at ~2 weeks.
(8) Laser effects on odor reduction may develop gradually over 1–3 months.
I highly recommend Alii Nani Aesthetic. I got treated here for my hyperhidrosis and it drastically helped with the sweat under my arms.- JC
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