Excessive sweating, or hyperhidrosis, is a common but still underrecognized condition that affects about 1 to 3 % of the population. It manifests as excessive sweating, localized or generalized, occurring unpredictably, regardless of ambient temperature or physical exertion.
In the majority of cases, it is a primary form, with no identified underlying cause. It often begins in adolescence and persists into adulthood. This condition may appear trivial to those around, but people who suffer from it describe intense daily discomfort, affecting social, professional, and intimate life.
L’hyperhidrose, ou transpiration excessive, n’est pas un simple inconfort. Du point de vue médical, il s’agit d’un trouble fonctionnel réel, reconnu. Il existe aujourd’hui des traitements efficaces et sûrs, validés par les autorités de santé. Il n’est donc pas nécessaire de « vivre avec » sans solution.
Dès lors que la transpiration est modérée à sévère et qu’elle impacte la qualité de vie, une prise en charge est recommandée. Le traitement dépend de plusieurs facteurs : la zone concernée (aisselles, mains, pieds, visage), l’intensité des symptômes, et les besoins spécifiques du patient.
Le traitement le plus utilisé reste la botulinic toxin, indiquée exclusivement en cas de hyperhidrose axillaire primaire. Ce traitement, bien connu en médecine, bloque temporairement l’activité des glandes sudoripares. Il est reconnu pour son efficacité, avec des résultats visibles en quelques jours et une bonne tolérance.
Parmi les témoignages recueillis en consultation, le soulagement apporté par les injections de toxine botulique est indiscutable. Les patients décrivent une amélioration nette, souvent dès la première séance. Ceux qui en bénéficient notent :
Un retour typique est « Avant le traitement, je changeais de chemise trois fois par jour. J’évitais les couleurs claires. Depuis les injections, je me sens libre. Je n’y pense plus. C’est un changement radical. »
Ce type de témoignage est courant, en particulier pour les personnes atteintes d’hyperhidrose axillaire, chez qui l’effet de la toxine botulique est à la fois visible, rapide et prolongé (6 mois en moyenne).
Some patients, at first, prefer to try gentle approaches : alum stone, essential oils, bicarbonate. These products can be useful for moderate sweating, but are rarely sufficient when it comes to true hyperhidrosis.
Many report their disappointment : “I tried all the ‘natural’ deodorants on the market. I had to change constantly, without results. At some point, I understood that it wasn’t a product issue, but a real medical condition.”
The general opinion of patients, once informed, aligns with the medical perspective : cosmetic solutions are rarely effective in established cases of hyperhidrosis. It is important to consult a doctor for proper medical management.
One important point to know concerns the renewal of treatment, especially in the case of botulinum toxin, whose effect is temporary. In general, a new injection is recommended every 5 to 6 months, depending on the case.
Contrary to what one might think, this renewal is well accepted by patients. Once the effects are observed and the discomfort disappears, the majority choose to continue the treatment regularly, without constraints. A typical feedback is, for example : “The treatment lasts barely half an hour, and the effect is spectacular. Honestly, I didn’t hesitate to do it again. It has become a reflex, like going to the dentist.”
On this subject, doctors and patients share the same observation :
Among them, botulinum toxin is often considered the reference treatment, especially for the underarms. It offers rapid results, a high level of satisfaction, and ease of use that promotes long-term adherence. Other treatments can be proposed depending on the case, but they are not as effective or simple.
L’un des aspects régulièrement abordés en consultation est la peur des effets secondaires, notamment pour les injections de toxine botulique. Avant de commencer le traitement, certains patients expriment des inquiétudes : douleurs lors de l’acte, réactions locales, ou effets sur la transpiration ailleurs dans le corps.
En pratique, les injections sont peu douloureuses : elles se font avec des aiguilles très fines, dans le derme, sans atteindre le muscle. Lorsqu’une anesthésie locale est nécessaire, elle est appliquée sous forme de crème ou de glace, et rend l’acte largement supportable. Les patients rapportent le plus souvent une sensation de picotement léger, parfois une petite tension, mais rarement une douleur significative.
Concernant les effets secondaires, les avis sont globalement rassurants. Dans la très grande majorité des cas, aucune complication n’est rapportée. Ces effets indésirables sont transitoires : une petite ecchymose au point d’injection, une sensation de tension musculaire dans la zone traitée, plus rarement, une faiblesse temporaire
Les médecins insistent sur un point : le respect de la bonne technique est essentiel. Lorsqu’il est réalisé par un praticien expérimenté, le traitement est sûr et les effets secondaires restent exceptionnels.
Quant à la transpiration compensatoire (transpiration qui apparaîtrait ailleurs sur le corps après le blocage d’une zone), elle est inexistante avec la toxine botulique. Ce phénomène, bien connu après certaines interventions chirurgicales, n’est pas observé avec les injections. Les patients, après traitement, confirment qu’ils n’ont pas noté d’augmentation de la sueur sur d’autres zones.
Many patients with hyperhidrosis have tried multiple solutions before consulting a specialist. Some started with over-the-counter antiperspirants containing aluminum salts. Others experimented with so-called “natural” deodorants, or even alum stone. In moderate cases, these approaches can be sufficient. But in the majority of moderate to severe cases, they prove disappointing in the medium term.
One patient reports : “I tried everything available on the market. At first it seemed to work, then the sweating returned. The underarm irritations were unbearable.”
This observation recurs regularly. Many patients describe a trial-and-error journey, often costly and frustrating, before considering a real medical solution.
Iontophoresis, often proposed for hands or feet, produces interesting results but requires repeated sessions, which can be inconvenient.
It is often after these attempts that patients turn to botulinum toxin, sometimes with skepticism, then with satisfaction.
More than just effectiveness, it is the stability over time that convinces : two sessions per year are sufficient in most cases, results are consistent, reproducible, and follow-up is simple. Patients find this solution quite convenient.
Finally, it is striking to see how much the treatment of hyperhidrosis transforms daily life. This change concerns not only the physical aspect — dry clothes, comfortable skin — but also the patient’s psychological state.
Feedback collected after treatment highlights deep relief, a feeling of liberation : “I no longer need to hide my hands. I shake hands without thinking about it. It’s as if I have regained a part of myself.” “I always wore black to hide marks. Now I can wear a white shirt without stress. I feel freer, more like myself.” “Before, I thought about my sweating all day. Now, I don’t think about it at all. It has freed me.”
These testimonies are all the more striking because they often come from discreet, reserved people who had long avoided talking about it. Access to this treatment allows them to break free from discomfort that has been present for years.
From a medical perspective, doctors confirm it : the psychological benefit is as important as the physical benefit.
In a world where non-verbal communication — handshake, proximity, eye contact — plays a central role, no longer being embarrassed by one’s sweating allows for social reintegration.
Article written by Dr Romano Valeria
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