Axillary hyperhidrosis is a condition where underarm sweat glands are overactive, producing excessive sweating even in cool environments or at rest — severe cases soak through clothing with obvious odor, affecting social life, work, and confidence. Causes include: (1) Primary hyperhidrosis — overactive sympathetic nervous system stimulating abnormal secretion from apocrine (large) and eccrine (small) sweat glands, often related to constitution and genetics. (2) Emotion-triggered — sympathetic excitation during tension, anxiety, or stress intensifying underarm sweating. (3) Metabolic factors — obesity, hyperthyroidism, menopausal hormonal changes may aggravate sweating. Previously, severe hyperhidrosis required surgery (sympathectomy); now botulinum toxin injection is the mainstream treatment: it blocks acetylcholine release, temporarily suppressing the sweat gland secretion signal — non-surgical, 15 minutes, no downtime. Rappoel Dermatology near Gangnam Station, Seoul, provides Coretox axillary hyperhidrosis treatment.
Technical Principles of Coretox Underarm Sweat Control
- Nerve signal blockade: Sweat glands are innervated by sympathetic nerves whose endings release acetylcholine to stimulate secretion — toxin is precisely injected into the sweat-gland-dense dermis, blocking acetylcholine release so glands do not receive the ‘sweat’ command and stop overproducing
- Iodine-starch test localization: Before injection, the Minor’s test is performed — iodine solution applied to the underarm followed by starch powder; sweating areas turn deep blue, precisely marking the sweat range to ensure all active gland areas are covered
- Grid injection: Grid-pattern injections at 1-1.5cm intervals across marked areas, 0.1-0.2ml per point, 15-20 points per side, approximately 50-100 units total per side (Coretox) — ensuring uniform coverage and avoiding missed areas that continue sweating
- Coretox characteristics: Coretox (Korean-manufactured toxin with the same type A botulinum 900kDa core protein as Botox) provides stable results, taking effect in 3-7 days, reducing sweat secretion by 80-90%, lasting 6-9 months
- Reversible and safe: Toxin effects fade over time (6-9 months) with sweat gland function fully recovering — unlike surgery’s irreversible risks, suitable for patients wanting safe improvement
Treatment Strategies for Different Sweating Concerns
- Underarm hyperhidrosis (high volume): Sweating clearly above normal, often soaking clothing. Strategy: iodine-starch test marking → full-area grid injection (50-100 units per side) — sweat reduction of 80-90%
- Underarm odor type (bromhidrosis): Apocrine secretions decomposed by bacteria producing odor. Strategy: injection focused on the apocrine-dense hair-bearing area with full marked-area coverage — suppressing apocrine secretion, markedly reducing odor (not completely eliminated, but sufficient for daily social life)
- Sweating with odor type: High sweating with obvious odor. Strategy: full-area grid injection (suppressing sweat) plus enhanced hair-bearing-area injection (suppressing apocrine glands) — dual improvement of sweating and odor
- Palmar-plantar involvement (concurrent): Some patients also have palmar or plantar hyperhidrosis. Strategy: underarm injection as the base plus palm/soles injection (20-50 units per side) — assess pain tolerance (palmar injection is more painful); Rappoel recommends treating the most bothersome site first
- Emotion-triggered type: Sweating worsens under stress. Strategy: underarm injection as the base plus stress management — the toxin already provides significant relief, with longer-lasting effects once emotions stabilize
Rappoel Coretox Underarm Treatment Protocol
- Consultation assessment (5 min): Take sweating history (volume, frequency, triggers, impact on life) → evaluate underarm skin condition and hair area → confirm suitability or rule out other conditions (e.g., hyperthyroidism)
- Iodine-starch test (5 min): Apply iodine solution to the underarm → dust with starch powder → wait several minutes → sweating areas turn deep blue → mark the sweat range with a marker
- Disinfection and anesthesia (5 min): Alcohol disinfection → topical anesthetic cream or local cooling (underarm skin is thin; nearly painless with anesthesia)
- Grid injection (10-15 min): Injections at 1-1.5cm intervals across marked areas → 0.1-0.2ml per point → 15-20 points per side → 50-100 units total per side → gentle pressure briefly
- Post-care instructions (2 min): Avoid showering and strenuous exercise for 4 hours → avoid rubbing the injection area, sauna, and alcohol for 24 hours → avoid antiperspirants and underarm hair removal on the day → sweating markedly decreases in 3-7 days, 2-week evaluation
Coretox underarm treatment takes about 15-20 minutes with no downtime; sweating decreases 80-90% in 3-7 days, lasting 6-9 months. Located 3 minutes from Gangnam Station Exit 10, with seamless English and Chinese consultation.
Frequently Asked Questions
What’s the difference between toxin underarm treatment and surgery (sympathectomy)?
Completely different principles and risks: (1) Toxin approach — non-surgical, 15-20 minutes, no downtime, reversible and safe; blocks acetylcholine to temporarily suppress sweat gland secretion; sweat reduction of 80-90%; lasts 6-9 months requiring regular touch-ups; no surgical risks. (2) Surgical approach — sympathectomy requires general or regional anesthesia, 1-2 weeks recovery, permanent results, but with real risks: compensatory hyperhidrosis (about 30-50% of patients develop abnormal sweating elsewhere) is the most common side effect, plus nerve damage and pneumothorax risks. (3) Rappoel’s recommendation — unless severe hyperhidrosis with toxin failure, prefer the toxin first: try the non-surgical approach, which is safe with already remarkable results.
How much sweating reduction can I expect? How long does it last?
Effectiveness data: (1) Reduction — effects begin in 3-7 days; sweating decreases on average 80-90%; most patients improve from ‘soaked shirts’ to ‘slightly damp or fully dry.’ (2) Duration — effects last 6-9 months; nerve endings regenerate and glands resume secretion afterward. (3) Touch-up frequency — every 6-9 months; regular touch-ups maintain long-term dryness. (4) Variance — results relate to injection coverage: the more precise the iodine-starch marking and complete the grid injection, the better the results. Rappoel uses the iodine-starch test to ensure 100% coverage of active gland areas. (5) Note — the toxin’s effect on ‘sweat volume’ is remarkable, and it also improves ‘odor’ (apocrine suppression), but complete odor elimination also requires good underarm hygiene.
Does underarm toxin injection hurt? Are there side effects?
Pain and side effects: (1) Pain — underarm skin is thin with fewer nerves; with topical anesthetic most feel only mild stinging, completing in 10-15 minutes, very tolerable. (2) Common side effects — mild redness and bruising at injection points (resolving in 3-5 days), brief soreness after injection (resolving in 1-2 days). (3) Rare — temporary local muscle weakness (very rare, usually from excessive volume or deep injection). (4) No systemic risk — the toxin acts locally, not entering circulation to affect the body. (5) Safety advice — choosing a proper clinic with experienced physicians is key; Rappoel uses iodine-starch localization for precise, safe results.
Who is suitable for toxin underarm treatment? Who is not?
Suitable and unsuitable groups: (1) Suitable — those troubled by underarm hyperhidrosis, bromhidrosis, social/work impact from sweating, those wanting to avoid surgical risks, athletes, and those spending long periods in public settings. (2) Unsuitable or cautious — pregnancy and breastfeeding (postpone), neuromuscular diseases such as myasthenia gravis (contraindicated), active underarm skin infection (treat first), toxin allergy. (3) Note — if hyperhidrosis stems from hyperthyroidism or menopause, treat the root cause first; the toxin serves as an adjunct. (4) Rappoel physicians take a full history during consultation and confirm suitability before treatment.
What should I do after toxin underarm treatment? Can I exercise immediately?
Post-care: (1) 4 hours — avoid showering, swimming, strenuous exercise, and lying on the injection area. (2) 24 hours — avoid rubbing the injection area, sauna, high-temperature environments, alcohol, antiperspirants, and underarm hair removal (laser removal recommended 1-2 weeks later). (3) One week — avoid intense underarm friction (e.g., heavy weightlifting); normal showering and daily activities are fine. (4) Effect observation — sweating decreases in 3-7 days with full effect at 2 weeks; if some areas remain active (missed coverage), touch-up in 2-4 weeks. (5) Long term — effects last 6-9 months; schedule touch-ups before effects fade to maintain stable dryness.
Underarm sweating ruining your day? Rappoel Coretox — 15 minutes to say goodbye to wet armpits!
📍 77, Seocho-daero, Seocho-gu, Seoul, South Korea
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