HYPERHIDROSIS TREATMENT
Botox® for excessive sweating
What Is Hyperhidrosis?
Hyperhidrosis is a medical condition characterised by sweating that is excessive for the temperature, activity level or situation. It can affect the underarms, palms and fingers, soles of the feet, face or scalp, and may interfere with clothing choices, work, social situations and everyday comfort.
"Almost 3% of the general population, largely people aged between 25 and 64 years, experience hyperhidrosis. The condition carries a substantial psychological and social burden, since it interferes with daily activities".
Source: Haider and Solish, Focal hyperhidrosis: diagnosis and management, CMAJ (2005)
There are two main types of hyperhidrosis, and understanding the difference is important because they are assessed and treated differently.
Primary And Secondary Hyperhidrosis
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.
Primary hyperhidrosis usually does not continue during sleep, although stress, heat and strong emotions can make it worse.
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 suddenly during adulthood and sometimes continues even during sleep.
Common causes include diabetes, thyroid disorders, menopause, certain medications, or infections. If excessive sweating begins suddenly, affects most of your body or regularly occurs overnight, 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 Primary Hyperhidrosis?
Sweating is normal and necessary because it helps the body regulate temperature. Primary hyperhidrosis is different. The sweat glands remain overactive and produce more sweat than the body needs, sometimes without any obvious trigger.
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.
Source: Haider and Solish, Focal hyperhidrosis: diagnosis and management, CMAJ (2005)
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 Botulinum Toxin Works For Excessive Sweating
Treatment works by temporarily interrupting the nerve signals that activate the sweat glands, reducing sweat production only where the botulinum toxin is injected. It temporarily blocks the release of acetylcholine, the chemical signal that tells the sweat glands to switch on. When injected just beneath the skin in a sweat-prone area, it reduces the excessive nerve signal reaching those glands.
The effect is localised to the treated area. Your body can still regulate its temperature and sweat normally elsewhere, including during exercise or hot weather.
At ALLOR, many patients begin to notice reduced sweating within two to four days, with the full effect developing by approximately two weeks. Most are advised to expect results to last around six to nine months, although the duration varies between individuals.
Which Areas Can Be Treated?
ALLOR regularly treats focal hyperhidrosis affecting the underarms. The dose, number of injections, and comfort measures are tailored to you and explained at your initial consultation. If excessive sweating affects you in other areas, please enquire and we can discuss your options at a consultation.
In some cases, a starch-iodine test may be used beforehand to identify and map the areas where sweating is most active. This is not required for every patient.
What Is A Starch-iodine Test?
A starch-iodine test, is a simple way to map active sweating. An iodine solution is applied to the skin and lightly dusted with starch. Areas that are actively sweating turn dark blue-black, showing where treatment should be concentrated.
The test is painless and takes only a few minutes. It is included in the underarm treatment price when it is needed for accurate mapping.
What Does The Clinical Evidence Show?
Botulinum toxin type A has been studied extensively for primary axillary hyperhidrosis. Clinical trials and reviews have shown substantial reductions in sweat production and improvements in quality of life, with benefits commonly lasting at least six months.
What Are The Side Effects?
Botulinum toxin is generally well tolerated for the treatment of excessive underarm sweating. The most commonly reported effects are mild and settle on their own - some people notice a slight, temporary increase in sweating in a nearby untreated area, along with mild soreness, warmth or tenderness at the injection site. A change in body odour has also been reported occasionally.
As with any prescription medicine, more serious reactions are possible but rare. If you notice unusual muscle weakness, or any difficulty swallowing, speaking or breathing after treatment seek medical advice promptly.
Step-By-Step: Your Botulinum Toxin Hyperhidrosis Treatment
Before Your Treatment: How to Prepare
The following are general preparation guidelines commonly recommended before botulinum toxin for hyperhidrosis treatment. Your individual situation may vary, and you should always follow personalised advice provided during your initial consultation.
1. Please avoid alcohol and blood-thinning medications (such as aspirin, ibuprofen and other anti-inflammatories) for 24 hours before treatment to minimise bruising and swelling. If caffeine noticeably increases your sweating, avoid it immediately before the appointment. If you take prescribed medications or have allergies, these will be discussed during your initial consultation. Do not stop any prescribed medications unless advised by your prescribing doctor.
2. Please come to your appointment with the treatment area hair-free and stop antiperspirant use in the area for 24 hours. This helps the treatment work better, as it facilitates injection precision within treatment areas and minimises the risk of infection.
3. Drink plenty of water in the days leading up to your treatment to support healthy, hydrated skin.
4. Wear loose clothing that allows easy access to the treatment area.
5. Schedule your treatment at least two weeks before any important events to allow time for settling and optimal results.
During Your Treatment For Excessive Sweating
1. Treatment typically takes around one hour.
2. In some cases, a starch-iodine test may be used before hand to map out the most active sweat areas, although this is not always necessary.
3. A series of precise injections are placed just beneath the skin, targeting the sweat glands in the affected areas (e.g. armpits).
4. Some people may experience slight pain or a pinching sensation at the injection sites, but it is generally well-tolerated. If you are uncomfortable with the sensation of needles, topical numbing agent and distraction devices can be used on request to minimise discomfort.
Immediately After Treatment: What You’ll Notice
1. There’s no downtime required - most people return to work or daily activities straight after. You may have mild redness or swelling at the injection sites, which fades quickly.
2. To ensure the best outcome, we provide you with clear aftercare instructions with a contact number. We also schedule a complimentary follow-up two weeks after your treatment to review your progress, answer any questions, and ensure you are happy with your results.
When Your Hyperhidrosis Treatment Results Start to Show
1. Many of our patients see results from treatment in as little as two to four days. From there, they continue to develop, with peak results emerging within two weeks. The exact time will depend on the individual.
2. During your two week follow-up, we’ll assess how your treatment has settled. In rare cases, a small top-up might be needed to fine-tune your results - if so, there will be a charge for the additional product used.
3. Dryness after excessive sweating treatments typically lasts between six to nine months, although results will vary slightly from person to person. You can usually expect to feel very dry ("bone dry") for the first few weeks, however this will settle to normal levels of sweating thereafter, before gradually becoming excessive again at the 6-9 month mark, when your next treatment will be due.
Hyperhidrosis Treatment Cost
Hyperhidrosis treatment at ALLOR Cosmetic Medicine is $1500 per session, which includes both underarms and initial starch iodine test (if needed) to identify affected areas on both armpits.
If excessive sweating affects you in other areas, please enquire and we can discuss your options at a consultation.
No one chooses to have hyperhidrosis, yet millions are affected by this medical condition. It can cause discomfort, embarrassment, and hinder lifestyle substantially.
Don’t let excessive perspiration get in the way of your life. To learn more about hyperhidrosis treatments for men and women in Auckland, BOOK NOW for an initial consultation today with ALLOR Cosmetic Medicine.
Frequently Asked Questions
What is hyperhidrosis and how can botulinum toxin help?
Hyperhidrosis is excessive sweating not caused by heat or exercise. Botulinum toxin helps by blocking the nerve signals that trigger sweat glands.
How should I prepare for treatment?
Patients should remove hair from treatment area, stop antiperspirant for 24 hours and arrive deodorant-free.
Can I have Botox® if I am pregnant or breastfeeding?
No. At ALLOR, we do not provide botulinum treatment if you are pregnant or breastfeeding.
This is a precaution because there is not enough safety data to confidently recommend botulinum toxin treatment during pregnancy or lactation. If you are planning pregnancy, pregnant, or breastfeeding, please let us know during your consultation so we can advise you safely and discuss timing.
What happens during the procedure?
The treatment takes about an hour and involves small injections into sweat-prone areas. Each injection feels like a brief pinch. Underarm treatment is usually well tolerated. Numbing cream or distraction techniques can be discussed during consultation.
What should I expect afterward?
You can return to daily activities right away. Mild swelling or redness may occur but usually fades quickly.
When will I see results?
Reduced sweating often begins within 2–4 days and peak at two weeks. Effects generally last 6–9 months.
How much does it cost?
Treatment at ALLOR is $1500 per session, including both underarms and testing if needed. If excessive sweating affects you in other areas, please enquire.
Written by Dr. Heather Anderson, MBChB, BSc, FRNZCUC, PGDip Cosmetic Medicine, NZSCM | ALLOR Cosmetic Medicine, Auckland
Reviewed and updated: July 2026
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.