HYPERHIDROSIS – EXPLORING TREATMENT FOR EXCESSIVE SWEATING

I see many patients who come to me feeling frustrated, embarrassed, or just plain tired of dealing with excessive sweating. This isn’t the kind of light perspiration most of us experience on a hot day or when we’re nervous. Hyperhidrosis is something else entirely - it can happen out of nowhere, and it often interferes with daily life in ways most people don’t talk about.

It affects confidence, comfort, and even simple things like what clothes you wear, how you greet someone, or whether you feel at ease in your own skin.

The good news? There’s a safe and highly effective treatment available. At ALLOR, we use botulinum toxin to treat hyperhidrosis by gently blocking the nerve signals that overstimulate your sweat glands. It’s especially effective in the underarms, but we also use it with great success on the hands, feet, and face.

Results usually begin within a few days, and for most people, the dryness lasts between six to nine months.

If you're curious whether this treatment might be right for you, we’ll walk you through exactly how it works, what to expect, and how we approach it here at ALLOR. Because once you understand your options, it becomes much easier to take that first step towards relief.

What is Hyperhidrosis?

Hyperhidrosis is a condition where your body produces far more sweat than it needs to. This isn’t about being hot or exercising - it’s a medical issue where the sweat glands become overactive, often without any clear trigger.

It is sweating that simply doesn’t match the situation. You might be sitting calmly in a cool room, yet still find your underarms, hands, or feet completely drenched. It can be unpredictable, and for many people, incredibly disruptive.

There are two main types.

Primary hyperhidrosis usually starts early in life, often during childhood or teenage years and tends to affect specific areas like the underarms, palms, soles of the feet, or face. It often shows up symmetrically on both sides of the body.

Secondary hyperhidrosis, on the other hand, tends to involve larger areas and is usually caused by an underlying medical condition or certain medications. This type is more likely to begin later in life and sometimes continues even during sleep.

 

Primary and Secondary Hyperhidrosis

Understanding the difference between these two types helps determine the best treatment approach for your specific situation.

Primary hyperhidrosis has no underlying medical cause that we can identify. Your sweat glands simply produce more sweat than necessary in response to normal triggers like stress, heat, or emotions.

Secondary hyperhidrosis results from another medical condition or medication. The sweating usually occurs across larger body areas and may happen during sleep.

Common causes include diabetes, thyroid disorders, menopause, certain medications, or infections. If you develop excessive sweating suddenly as an adult, we recommend investigating potential underlying causes with your family doctor (GP).

Primary hyperhidrosis is more common and responds well to treatments like Botox® injections. Secondary hyperhidrosis often improves when the underlying medical condition is addressed.

What Causes Hyperhidrosis?

The exact cause of primary hyperhidrosis remains unclear, but does involve your sympathetic nervous system sending stronger signals to your sweat glands than necessary.

Genetic factors also play a role. About 30 - 50% of people with hyperhidrosis have family members with the same condition (Haider A, Solish N. Focal hyperhidrosis: diagnosis and management. CMAJ. 2005;172(1):69–75).

Emotional triggers like stress, anxiety, or embarrassment can worsen symptoms. Many patients say their sweating increases in social situations, which creates a cycle where worry about sweating causes more sweating.

Physical triggers include heat, spicy foods, caffeine, or physical activity. However, people with hyperhidrosis sweat excessively even without these triggers.

The condition isn't related to fitness level or personal hygiene. Hyperhidrosis is a legitimate medical condition and not something you can control through willpower alone.

How Sweat Glands Work

To really understand how we treat hyperhidrosis, it helps to first understand what’s going on with your sweat glands.

Your body has two main types of sweat glands: eccrine and apocrine. The eccrine glands are the ones we focus on when treating hyperhidrosis - they’re small, numerous, and found all over your body. They produce the clear, odourless sweat that kicks in when your body’s trying to cool itself down.

How Botox® Works for Excessive Sweating

When we’re treating hyperhidrosis, the goal is to calm the overactive sweat glands in specific areas without affecting the rest of your body’s ability to regulate heat. That’s exactly what Botox® allows us to do.

Botulinum toxin works by blocking the nerve signals that normally tell your sweat glands to turn on. When injected into the right area, it essentially creates a temporary barrier between your nerves and sweat glands so your glands simply stop overproducing sweat.

The result? Far less sweating - without affecting your body’s ability to regulate temperature in other areas. You’ll still sweat naturally where you need to, like during exercise or in the heat. But in the areas we’ve treated, the overactive response is switched off.

The effects typically begin within 2 to 4 days and can last up to nine months.

Common treatment areas include:

• Underarms (most popular)

• Palms and fingers

• Soles of feet

• Face and scalp for facial hyperhidrosis

The beauty of this treatment is its consistency. Research shows that patients typically see a significant reduction in sweat production, with many experiencing up to 80 - 90% average reduction in sweating in treated areas.

I find that patients are often amazed by how quickly their quality of life improves. Within weeks, they're choosing clothes based on style rather than sweat concealment.

What to Expect from a Botox® Treatment for Hyperhidrosis

We recommend stopping any antiperspirants 24 hours before your appointment and shaving the treatment area. This helps us see exactly where your sweat glands are most active.

You'll want to avoid blood-thinning medications and alcohol for 24 hours before your session. Also, avoid active skincare ingredients like retinoids or exfoliants for 3 - 5 days beforehand on the treatment area.

On the day of treatment:

• Wear loose, comfortable clothing

• Arrive with clean, deodorant-free, hairless skin

• Avoid caffeine, which can increase sweating

• Bring a list of current medications

If needed, we may perform a starch-iodine test to help map the sweat-prone zones before treatment.

The injection process is straightforward but requires precision. we use a very fine needle to inject small amounts of product just under the skin surface.  Each injection feels like a quick pinch. Most people find the discomfort minimal and brief. Numbing cream or distraction tools can be used to enhance comfort.

Results, Safety and Potential Side Effects

Most patients begin seeing improvement in 2 to 4 days, with peak dryness usually by 2 weeks. You’ll likely feel very dry for the first few weeks, before returning to pre-treatment levels around the 6 - 9 month mark.

Botox Side Effects for Treating Hyperhidrosis

Side effects are generally mild and temporary:

• Redness or swelling at injection sites

• Soreness or slight bruising

• Muscle weakness near treated areas (less common)

• Rarely, compensatory sweating in untreated zones

Complications are very rare when the treatment is performed by an experienced practitioner.

Is Botox® Right for You?

You may be a good candidate if:

• Excessive sweating affects your daily life

• You've tried antiperspirants without relief

• You prefer a non-surgical option

• You want targeted results in specific areas

We’ll assess your medical history and lifestyle at your consultation to ensure this is the safest, most effective approach for you.

If hyperhidrosis is holding you back, let’s change that. Book a consultation and we will guide you through your choices step by step. Book online or reach out to the clinic today.

Botox®, Prescription Medicine For the treatment of frown lines and crow’s feet around the eyes.  Botox® has risks and benefits. Ask your doctor if Botox is right for you. Botulinum toxin type A 50, 100, 200 Units. For product information check with your doctor or Consumer Medicine Information on www.medsafe.govt.nz. Click for further details. Allergan, Auckland.