Pitting out is an informal term for excessive underarm wetness and resulting clothing stains. Medically, this condition is known as axillary hyperhidrosis, characterized by sweating that exceeds the body’s needs for temperature regulation. Managing axillary hyperhidrosis often involves a stepped approach, starting with accessible products and progressing to clinical treatments and lifestyle adjustments.
Optimizing Over-the-Counter Antiperspirants
The first line of defense against excessive underarm wetness is the correct use of over-the-counter antiperspirants. Unlike deodorants, which primarily mask odor, antiperspirants actively reduce sweat production. Their active ingredients are aluminum-based compounds, such as aluminum chloride or aluminum chlorohydrate.
These metallic salts dissolve in skin moisture, forming a temporary physical plug within the sweat duct. This blockage prevents sweat from reaching the skin’s surface, thereby reducing wetness. For maximum effectiveness, antiperspirants, especially clinical-strength versions, should be applied at night to completely dry skin. Applying at night allows the aluminum plug to form undisturbed while sweat glands are less active during sleep. The antiperspirant should then be washed off in the morning.
Clinical Interventions for Excessive Sweating
When standard antiperspirants do not provide sufficient relief, a healthcare provider may prescribe a topical agent with a higher concentration of aluminum chloride, often up to 20%. This prescription-strength solution is used similarly to its over-the-counter counterpart, applied to the affected area at night. Due to its higher strength, skin irritation is a common adverse effect.
For cases that are refractory to topical treatments, botulinum toxin injections, commonly known as Botox, are an effective second-line therapy for axillary hyperhidrosis. The neurotoxin is injected superficially into the armpit skin, where it works by blocking the release of acetylcholine, the chemical messenger that signals the sweat glands to produce sweat. This treatment can reduce sweating significantly, with the effects typically lasting between three to nine months before a repeat treatment is required.
Managing Lifestyle and Clothing Factors
Beyond topical and clinical treatments, certain lifestyle adjustments can help manage sweat episodes. Dietary choices influence sweating, as stimulants like caffeine, spicy foods containing capsaicin, and alcohol can activate the nervous system and trigger hyperhidrosis. Stress and anxiety are also common triggers, making stress management techniques such as deep breathing or mindfulness beneficial. Reducing or avoiding these triggers may decrease the frequency of sudden sweat production.
Clothing choices are important for managing the appearance of wetness and comfort. Opting for loose-fitting garments made from natural, breathable fabrics like cotton or bamboo can help regulate body temperature and wick moisture away. Darker colors and busy patterns are also useful for minimizing the visibility of any sweat marks.
When to Consult a Healthcare Provider
It is important to understand the two main types of hyperhidrosis to know when to seek medical advice. Primary focal hyperhidrosis is localized, typically affects the underarms, hands, or feet, and usually begins in childhood or adolescence without an apparent cause. Secondary generalized hyperhidrosis, however, is sweating that affects larger areas of the body and is a symptom of an underlying medical condition, such as a thyroid disorder, diabetes, or an infection.
You should schedule an appointment with a healthcare provider if your sweating suddenly increases or begins to occur at night, as night sweats are a common sign of secondary hyperhidrosis. A doctor’s visit is also warranted if the excessive sweating is accompanied by other systemic symptoms like dizziness, chest pain, or fever. Addressing the underlying cause of secondary hyperhidrosis is the primary method for resolving the excessive sweating.