Hyperhidrosis is the condition characterized by increased sweat in excess of that required to cool the body. It is usually present on the palms, feet and underarms. Although there are variations in perspiration of individuals, most people sweat during physical activity, stress, tension or staying in an overheated room. Excessive sweating in hyperhidrosis exceeds the natural amount of sweating.


Classification of hyperhidrosis


Hyperhidrosis can be classified into primary and secondary. The cause of the primary (Essential or idiopathic) hyperhidrosis is unknown. Secondary hyperhidrosis occurs as a consequence of other disorders such as endocrine disorders (hyperthyroidism), adrenal tumors (pheochromocytoma, carcinoid tumor), pituitary tumors, tuberculosis, diabetes mellitus, lymphomas, use of certain drugs. Only primary hyperhidrosis can be treated with botulinum toxin.



Symptoms of hyperhidrosis


The symptoms of hyperhidrosis are often noticeable sweating, which penetrates through clothes, disturbing and excessive sweating of the feet, underarms, head and face and beads of sweat on hands and feet. A huge percent of people has hyperhidrosis, 3% of the general population. It occurs in childhood or puberty, manifesting itself almost daily. It is more likely to occur among men. Hyperhidrosis is an inherited, if it is present in parents, the risk for a child is 25%.

It represents significant psychological (embarrassment, tension, loss of confidence) and social problem.


Complications which occur during excessive sweating may be in the form of fungal or bacterial infections and rashes.



Treatment of hyperhidrosis


- Dietary regimen

- Antiperspirants and deodorants

- Medicines

- Iontophoresis

- Botulinum toxin

- Thoracoscopic sympathectomy - the only therapeutic procedure that has a lasting effect!!!

- Treatment with Nd YAG laser (Laser Sweat Ablation)


Botulinum toxin is a muscle relaxant that is injected into muscles or deep into the skin. It blocks the transmission of nerve impulses in the muscles and prevents contractions. In the skin it affects the gland and reduces the amount of sweat. It blocks the release of acetylcholine from neuromuscular junction and thus temporarily excludes the innervation of the sweat glands. It is performed by intradermal injection in certain parts of the body (palms, armpits). The intervention has to be repeated at certain intervals that a patient determines based on the intensity of re-sweating.


The treatment of hyperhidrosis with Botulinum toxin A is recommended as a second therapeutic measure, following topical application of antiperspirants and deodorants. This form of therapy has proven to be very successful and safe for patients, there is no reason to fear if intervention is supervised by qualified person. Botulinum toxin is approved for use in children over 2 years for therapeutic purposes.




Botulinum toxin should not be used in patients with:


- Inflammation of the skin or muscle,

- A chronic disease that affects the muscles (e.g., myasthenia gravis)

- Motor neuron disease (amyotrophic lateral sclerosis) or motor neuropathy,

- Operations or injuries of the place of application,

- Pregnant women and nursing mothers.


The technique of application is very simple, minimally invasive and safe for patients. Intervention is short, comfortable and adapted to the patient.