Hyperhidrosis: Treatment of excessive sweating tendency

Stay cool! And sweat less.

Anyone who regularly uses public transport knows the problem: many people suffer from sweat gland overproduction, also known as hyperhidrosis. They sweat more than normal, especially in the armpits, palms, or feet. Two treatments have proven to be extremely effective for hyperhidrosis.

What is hyperhidrosis – and how many people are affected?

Sweating is vital to survival – it regulates body temperature and protects us from overheating. Yet, in an estimated 1 to 3 percent of the population, the sweat glands constantly run at full speed, even without physical exertion or heat. This is known as hyperhidrosis – a medically recognized condition that is much more than a cosmetic problem.

Particularly commonly affected are the armpits (axillary hyperhidrosis), the palms of the hands (palmar hyperhidrosis), and the soles of the feet (plantar hyperhidrosis). Many sufferers experience considerable distress: soaked clothing, avoiding handshakes, skipping social situations—hyperhidrosis can noticeably restrict everyday life and heavily burden self-confidence.

Important to know: You do not simply have to live with this. There are effective, proven treatment methods—both for rapid symptom relief and for a lasting solution. At our clinic in Berlin-Charlottenburg, we offer both approaches.

Botulinum toxin for hyperhidrosis – how the treatment works

Through regular injection of Botulinum toxin, also known as Botox® or Dysport, allows the nerve fibers responsible for sweating to be blocked. After four to eight days, sweat production stops completely by one hundred percent, but starts again after four to six weeks. Therefore, regular treatment is unavoidable for lasting success.

Treatment with botulinum toxin (Botox®, Dysport) for hyperhidrosis is fast, effective, and well tolerated. The neurotoxin temporarily blocks the nerve signals that stimulate the sweat glands to produce sweat—completely without surgery.

Procedure in our clinic:

• The treatment area (usually both armpits) is marked with an iodine-starch solution – this makes active sweat glands visible (Minor's test).
• Upon request, a numbing cream will be applied.
• Botulinum toxin is injected superficially into the skin using very fine needles – the procedure takes about 20 to 30 minutes.
• After 4 to 8 days, sweat production in the treated area is completely stopped.
• The effect usually lasts 4 to 6 months. With regular repetition, the intervals often become longer.

For statutory health insurance policyholders, the treatment may be reimbursable under certain circumstances if there is a proven medical indication – please check with your health insurance provider. Dr. Juliane Bodo is a panel physician and can discuss the requirements with you.

Suction curettage – the permanent solution

We achieved great success in many patients with suction curettage of the sweat glands. Here, under local anesthesia, we suction like a Liposuction the sweat glands under the armpits using fine cannulas. While we cannot remove all the glands, sweat production is reduced by 80 percent. This roughly corresponds to „normal“ sweating during physical exertion and heat. However, this procedure can only be performed in the armpits.

For those who do not want regular treatments and are looking for a long-term solution, sweat gland suction curettage is the more convincing option. This minor surgical procedure is performed under local anesthesia in our private clinic in Berlin-Charlottenburg – on an outpatient basis, in about 1 hour.

What exactly happens during this procedure? Very fine cannulas are used to specifically suction the sweat glands out of the subcutaneous fatty tissue of the armpits. Since the glands are mechanically destroyed in the process, they do not grow back. While not all glands can be completely removed, the remaining sweat production is reduced to a normal level comparable to sweating during physical exertion. Unpleasant or uncontrolled sweating at rest thus becomes a thing of the past.

After the procedure, you will wear a compression garment for 2 weeks. After 3 days, you are usually fit to socialize again. The risk of scars is very low with our gentle technique.

Palmar hyperhidrosis

Anyone specifically seeking treatment for palm sweating should keep in mind that this is only possible by severing a nerve at the spinal nerve plexus. This is a very complex and complicated surgery. It is not performed by us, but by specialized thoracic surgeons (e.g., at the Charité). Botox treatment would be significantly less complicated, but not permanent.

What about naturopathy?

Sometimes sage or valerian also helps against excessive sweating. In individual cases, there is very good success. Unfortunately, this cannot (yet) be scientifically measured.

Frequently asked questions about hyperhidrosis treatment with botulinum toxin