What is hyperhidrosis?

            Hyperhidrosis is the excessive sweating of the body that is released by the secretory sweat glands that are located almost all over the surface of the skin. It is not due to external factors such as temperature rise but is a pathological condition that affects a large part of the population.

Hyperhidrosis is divided into two types:


  • primary: sweating located in specific areas of the body, the armpit, sole and palm (focal hyperhidrosis) and is a genetic predisposition.
  • generalized: sweating occurs all over the body and to a large extent is associated with diseases such as thyroid, anxiety or hormonal disorders or drugs that cause excessive sweating as a side effect.
  • What is the treatment of hyperhidrosis with botulinum toxin?

Treatment of hyperhidrosis with botulinum toxin is considered as one of the most effective methods of combating excessive sweat secretion and especially in primary focal hyperhidrosis. Botulinum toxin contains a type A protein that causes reversible chemical denervation in muscles to reduce their rate of contraction and inhibit the function of the myoepithelial cells of the sweat glands. Sweat toxin is reduced by 70 – 90% thanks to the contribution of botulinum.


  • At what age can one start treatment?

Increased sweat production is a phenomenon that afflicts people of all ages and sexes. It is most strongly observed in people who are over 20 years old but can often appear in adolescence. Excessive sweating can create problems in interpersonal contacts both professionally and personally and socially. That is why those who want to get rid of the uncomfortable feeling caused by hyperhidrosis in a safe and painless way participate in the treatment.


  • What kind of medical examinations will be needed before the treatment of hyperhidrosis with botulinum toxin?

For the diagnosis of hyperhidrosis, the candidate’s medical history is retrieved first, followed by a qualitative and quantitative evaluation of the affected areas. For the quality assessment, the starch-iodine test (Minor test) is performed, which will undertake the detection of the areas that show high secretion of sweat. Specifically, a solution of iodine and then starch powder is placed on the affected areas that after a while will highlight them, a purple or dark black color appearing. The current situation is then quantified by depositing a special absorbent paper that will determine the degree of sweating.


  • Is the treatment painful?

The treatment of hyperhidrosis is completely safe and painless. The candidate only reacts when the botulinum toxin is injected into the injection points due to the superficial penetration of the needle into the skin. Depending on the candidate’s temperament, the procedure may be a bit painful in the palm area due to the nerves that run through it.


  • What complications may occur?

Botulinum toxin is widely known in the medical industry for its multiple applications as a regenerative and restorative material in areas that need its muscle relaxant properties to combat each problem. The presence of an allergic reaction to it is extremely rare. Also, treatment with botulinum toxin does not give a permanent effect, since the tissues repair the inactivation of the sweat glands and so the treatment is reversible.


  • How long does the procedure last and what kind of anesthesia is applied?

The anhidrosis process takes 20-30 minutes depending on the number of treated areas. To minimize the pain, an anesthetic cream is applied that acts by numbing the area.


  • What happens during the treatment of hyperhidrosis with botulinum toxin?

The points that show strong sweating are initially drawn. An anesthetic cream is then applied to soften the stinging sensation when the protein is injected. Intradermal injections are performed gradually at an angle of 170 ° to the selected areas. The injection (0.1 ml) of the botulinum toxin type A at the injection points creates temporary anhidrosis that becomes apparent after two days.


  • In how many days can one return to their daily activities?

This treatment is not accompanied by restrictions in daily life, as it does not require a certain recovery time. The candidate can return to work and daily activities undisturbed by paying attention only to his exposure to sunlight and avoiding alcohol consumption for 3 days.


  • When is repeat treatment recommended?

The results of the treatment last for about 8 months depending on the area in which the injections are applied. Because the botulinum toxin reduces sweat secretion but does not stop it completely, it is recommended to have the session repeated as soon as the percentage increase in sweat begins to be felt after intense physical exercise or after a stressful situation.


  • Results

Treatment of hyperhidrosis with botulinum toxin is specialized in primary focal hyperhidrosis and results in a significant reduction in sweat overproduction. From the first 2-5 days the results are visible, with the candidate not sweating to the same degree as before and enjoying their social gatherings and hobbies without stress and hesitation. The results are immediate and impressive.


Get proper and responsible information from the Plastic Surgeon Akis G. Karamatsoukis.

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