Hyperhidrosis is a condition that causes excessive sweating from the eccrine sweat glands, regardless of temperature or physical activity. It affects a large portion of the population and can have a negative impact on quality of life.

Types of Hyperhidrosis

There are two main types of hyperhidrosis:

  • Primary Focal Hyperhidrosis: This is the most common form. The exact causes are not fully known, but it appears to be linked to an overstimulation of the sympathetic nervous system and often has a hereditary predisposition. Emotional disturbances and an increase in environmental temperature worsen sweating and significantly affect patients. It is localized to specific areas of the body, such as the:
    • Armpits
    • Palms and soles
    • Face
    • Scalp
  • Secondary Generalized Hyperhidrosis: This is caused by an underlying medical condition or situation, such as:
    • Endocrine disorders (e.g., hyperthyroidism, diabetes)
    • Neurological disorders
    • Neoplasms and paraneoplastic conditions
    • Taking certain medications (antidepressants)
    • Menopause
    • Infections

In this case, sweating is usually generalized, affecting the entire body. It typically appears in adulthood or after a specific event (e.g., an accident or medication use). The treatment for secondary hyperhidrosis focuses on addressing the underlying cause.

Available Treatments for Primary Hyperhidrosis

To treat primary hyperhidrosis, there are several effective therapeutic options:

  • Topical Antiperspirants: These are special products based on aluminum chloride that reduce sweating. They are an initial option for mild cases. The patient should use an antiperspirant, not a deodorant, before going to bed, following the dermatologist’s instructions.
  • Iontophoresis: A device that uses a low electric current to temporarily inhibit the sweat glands. This is primarily an option for hyperhidrosis of the palms and soles.
  • Botulinum Toxin Injections (Botox/Dysport): This is the most modern and popular treatment. The botulinum toxin is injected into the affected areas (armpits, palms, soles) and blocks the nerve signals that activate the sweat glands. It is a quick, painless, and effective procedure. The results usually last for 6-9 months, and in some cases can reach up to a year, especially in the armpits. The treatment needs to be repeated when the effect wears off.
  • Invasive Treatments: In more severe cases, invasive methods may be considered, such as:
    • Thoracoscopic Sympathectomy: A surgical procedure that is rarely performed anymore, as it can have side effects like compensatory sweating (sweating in another area of the body).
    • Laser or Microwave Treatments (e.g., miraDry): These are more modern techniques for the permanent treatment of underarm hyperhidrosis.

It is important to consult a dermatologist to determine the appropriate treatment for your case. They can help you find the most effective solution and significantly improve your quality of life.

Hyperhidrosis Treatment at Our Clinic

At our dermatology clinic, we use botulinum toxin (Botox/Dysport) to treat hyperhidrosis.

Botulinum toxin therapy (Botox or Dysport) is one of the most popular and effective methods. It is a simple, quick, and almost painless procedure performed in the office.

How the treatment is done step-by-step:

  • Diagnosis and Planning: The dermatologist examines the affected area (armpits, palms, soles, face) and may use a special test (starch-iodine test) to accurately map the areas where sweating is most intense. This identifies the precise points for the injections.
  • Area Preparation: Before the injection, the area is cleaned. Depending on the patient’s sensitivity, a topical anesthetic cream may be applied, especially for more sensitive areas like the palms and soles, to make the procedure as painless as possible.
  • Injection Procedure: The doctor uses a very thin needle to perform multiple micro-injections of botulinum toxin, about 1-2 centimeters apart, across the entire problematic area. This substance acts locally, temporarily blocking the nerve signals that instruct the sweat glands to produce sweat.
  • Duration and Recovery: The entire procedure takes approximately 20-30 minutes. After the treatment, the patient can immediately return to their daily activities, only avoiding intense physical exercise or using a sauna for the next 24 hours.

Results and Duration

  • When results appear: The reduction in sweating is gradually noticeable within 2-4 days, with the maximum effect achieved in about 2 weeks.
  • How long they last: The results are not permanent, as the effect of botulinum toxin wears off over time. The duration of the result varies depending on the area and the patient, but it usually ranges from 6 to 12 months in the armpits and 4 to 9 months in the palms and soles.
  • Repeat Treatment: When the results begin to fade, the treatment can be repeated. Regular repetition can, in some cases, extend the duration of the effect.

Botulinum toxin therapy is considered to be very safe and effective (up to 95%), as it specifically addresses excessive sweating without affecting the body’s overall thermoregulation.