Do you sweat more than the situation calls for, even at rest or in cool conditions? This page calmly explains what hyperhidrosis is and what options exist.
The complaint
De klacht
Sweating is a normal bodily function that regulates your temperature. With hyperhidrosis, you produce more sweat than is needed to cool down, often unrelated to heat or exertion. The complaint may be limited to certain areas, such as the armpits, palms, soles of the feet or the face, or it may affect the whole body. For many people, the daily impact is significant, from soaked clothing to discomfort during a handshake or meeting.
Mogelijke aanpak
For localised, persistent hyperhidrosis, treatment with botulinum toxin can be considered. Small amounts are injected just under the skin, temporarily reducing the nerve signals that stimulate the sweat glands in that area. The effect is not permanent and typically lasts several months, after which the treatment can be repeated. Whether this is suitable for you depends on the location, severity and previous treatments, and is discussed during a consultation.
Botulinum toxin addresses the problem locally and does not treat the underlying cause. If a medical cause is suspected or if sweating occurs all over the body, a broader assessment, often together with your GP, is recommended first.
Excessive sweating is more than a cosmetic inconvenience. It can dictate your clothing choices, strain social situations and undermine your self-confidence. Some people avoid light-coloured clothing, a handshake or activities where they fear sweat patches. Recognition is the first step: many people think for years that they simply sweat a lot, while there are indeed options to reduce the burden.
Broadly speaking, two forms are distinguished. In primary (or focal) hyperhidrosis, it usually concerns specific areas such as the armpits, hands, feet or face, and the complaint often begins at a young age without a clear underlying disease. The stimulation of the sweat glands is then overactive. In secondary hyperhidrosis, there is an underlying cause, for example hormonal fluctuations, a thyroid problem, certain medications, infections or other conditions. This form often develops later in life, can affect the whole body and may also occur at night.
This distinction is important because the approach differs. A localised treatment is intended for the first form. If an underlying cause is suspected, a medical examination should come first, addressing the actual cause.
An assessment is advisable when sweating noticeably interferes with your daily life, when it starts suddenly or clearly worsens, when it is accompanied by other symptoms such as weight loss, fever or night sweats, or when it occurs all over the body. In those situations, it is wise to work with your GP to see whether an underlying cause is at play before considering a localised treatment.
The approach usually starts with the simplest measures and is only expanded if they provide insufficient relief.
In a hyperhidrosis treatment, small amounts of botulinum toxin are injected with fine needles just under the skin, distributed across the area that sweats excessively. The substance temporarily interrupts the nerve signal that stimulates the sweat glands, reducing sweat production in that area. The effect does not appear immediately but builds up in the days after the treatment.
It is a temporary result. In the armpits, the effect often lasts several months, roughly in the range of 4 to 9 months, after which the treatment can be repeated. The duration varies from person to person and per area. The palms and soles are more sensitive, and treatment there can cause more discomfort.
Botulinum toxin for hyperhidrosis can be an option when it concerns a clearly defined area, the complaint is persistent and simpler measures have not helped enough. It is not intended as a first step and is not suitable when an underlying cause is at play that must be treated first. The treatment is not recommended during pregnancy and breastfeeding, with certain muscle or nerve disorders, with a known hypersensitivity to the substance, and with an infection or skin problem at the injection site. Also, with sweating all over the body, a localised treatment is usually not the right choice.
As with any medical procedure, side effects are possible. Around the injection sites, temporary redness, small bruises or tenderness may occur. When treating the hands, there is a chance of temporarily weaker sensation in the hand muscles. Rarer reactions are possible and are discussed during the consultation. Important to know: the treatment reduces the complaint in a specific area, but does not cure hyperhidrosis and does not address any underlying cause.
Everything starts with a consultation. During it, your complaints, the areas involved, your medical history and previous treatments are discussed. Based on that, it is assessed whether a localised treatment makes sense or whether a broader medical assessment is indicated first. When a botulinum toxin treatment is appropriate, it is explained what you can expect, how the treatment proceeds and what the expected effect and duration are. The treatment itself usually takes a limited amount of time and is performed with fine needles. Any costs are discussed neutrally during the consultation.
Not everyone needs an injection treatment. For many people, adjusted antiperspirants, iontophoresis or, in specific cases, medication provide sufficient relief. The choice depends on the area, the severity, your preferences and what you have already tried. A consultation helps to choose together the step that fits your situation, without unnecessary procedures.
Dr. De Smedt explains
Sweat glands are controlled by nerve signals. Botulinum toxin interrupts that signal locally, so that the glands in the treated area temporarily produce less sweat. Because the body restores that connection over time, the effect is not permanent and the treatment can be repeated. It is a targeted, localised solution and not a treatment for any underlying cause.
Dr. Thierry De Smedtaesthetic physician, Ghent
Wat je mag verwachten
Risico’s en wanneer niet
Frequently asked questions
Every situation is different. During a consultation in Ghent, you receive a personal medical assessment and honest advice about what is and is not useful.
