Hyperhidrosis - excessive sweating

Excessive sweating, known as hyperhidrosis, is a very unpleasant and shameful issue for those affected. Large sweat patches and light-coloured sweat marks under the armpits or wet hands give others the impression that they are overly stressed and insecure. It is therefore difficult for those affected to interact openly with other people in their private and professional lives, and their daily routine is characterised by repeated changes of clothing and other concealing measures.

What causes excessive sweating?

The sweat glands in our skin are connected to nerve endings of the involuntary (autonomic) nervous system. This controls numerous bodily functions without our conscious will, such as heart rhythm, blood pressure, digestion and heat balance. As a rule, sweating serves to release heat. During stress or unusually high activity of the autonomic nervous system, increased nerve impulses can be sent to the sweat glands, so that those affected start to sweat even when it is cold and, above all, without wanting to, where most of the sweat glands are found in the skin: in the armpit, on the hands and feet.

Symptoms of hyperhidrosis

Depending on the cause, hyperhidrosis is divided into two main categories, which also differ in terms of symptoms:

Primary hyperhidrosis: is genetic and is often localised, for example on the hands, feet or in the armpits. It usually begins in childhood or adolescence and is independent of external influences or illnesses.
Secondary hyperhidrosis is a consequence of certain illnesses or the intake of medication and can affect the entire body. Causes can include hormonal disorders or changes (e.g. menopause), diabetes, infections or neurological diseases.

When does it make sense to treat excessive sweating?

It makes sense to treat hyperhidrosis if it affects your quality of life. This applies in particular to difficulties in everyday life, social or occupational impairment, skin problems or psychological stress caused by sweat.

What treatments do we offer?

We offer various methods for the treatment of hyperhidrosis. One of the most effective and most frequently used methods is treatment with Botox - the alternative would be surgical treatment (although this is only possible in the axillary area).

Treatment of hyperhidrosis with Botox

Brief overview of treatment with Botox:

Duration of treatment:
15-45 minutes

Anaesthesia:
as a rule none

Follow-up treatment:
not special

Load restrictions:
none - no sport for one day

In almost all cases, a superficial injection of the drug botulinum toxin type A into the uppermost layer of skin in the affected areas can reduce sweat production by around 90 per cent without surgery. Botulinum toxin inhibits the transmission of very specific nerve impulses to the sweat glands by blocking the release of the neurotransmitter acetylcholine, which is responsible for this.

Other nerve functions such as feeling or touch are not affected. The results of the treatment generally last for a period of four to six months. If desired, the treatment can then be repeated.

How long does Botox last for hyperhidrosis?

The desired effect usually lasts for around six to nine months. In individual cases, the effect can last longer. Subsequently, a new treatment is typically required.

How much does Botox cost for hyperhidrosis?

The costs depend on the amount of work involved. In most cases, the cost of treatment with Botox is between EUR 400 and EUR 1000.

Surgical treatment of excessive sweating

Brief overview of surgical treatment:

Operation duration:
45-70 minutes

Anaesthesia:
Anaesthesia or twilight sleep, combined with a local anaesthetic

Follow-up treatment:
none

Load restrictions:
1 - 2 weeks

Surgical by suction and scraping (curettage) of the armpits using special, thin instruments, which promise a lasting improvement. The surgical procedure can be performed on an outpatient basis and under local anaesthetic.

Is it possible to operate on sweaty hands?

We do not perform this procedure.

Who pays for the Botox treatment or the operation?

In most cases, the treatments are not medically necessary. Therefore, the costs are usually borne by the patients themselves.

How many people suffer from excessive sweating?

Around 3 % of the population suffer from hyperhidrosis, a condition characterised by excessive sweat production. In some cases, sweating occurs even without physical exertion. Those affected often suffer greatly from the social and occupational effects of the condition and are looking for effective treatment options.

Can I check for myself whether I have hyperhidrosis?

An exact medical diagnosis can only be made by a doctor. However, there are some signs and methods you can use to check for yourself whether you may be suffering from hyperhidrosis. These include

Observe whether you sweat excessively, even if you do not exert yourself physically or if you start sweating even in colder temperatures.
Pay attention to whether the sweating is so severe that it interferes with your daily activities or social life.
Use a diary to record when and under what circumstances you sweat heavily.

If you notice that you are suffering from these symptoms, you should consult a doctor so that an accurate diagnosis can be made and, if necessary, appropriate treatment can be given.

What should you look out for when choosing a doctor?

When choosing a specialist, make sure that you use the term Specialist in Plastic and Aesthetic Surgery. Other designations such as beauty doctor, cosmetic surgeon, etc. are unprotected and not a sign of qualification (more on "What should you consider when choosing a specialist?„.

Make sure that you receive a comprehensive preliminary examination and information about the course of treatment, possible risks and the healing process.

Why should you come to us?

Extensive experience, maximum hygiene and infection protection, continuous further training and the utmost care are the basis of our practice. This is also reflected in the large number of positive patient reviews and our seals & awards.

Take advantage of our almost 20 years of experience for your desired change. Dr Michaela Montanari has been a member of the board of the German Society for Aesthetic Plastic Surgery (DGÄPC) since 2021.

Do you have any questions?

We will be happy to answer all your questions about the procedure, options and risks of hyperhidrosis therapy. Arrange your personal consultation. We will advise you individually about your options.