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.
Hyperhidrosis, or excessive sweating, is not just a simple discomfort. From a medical perspective, it is a real and recognized functional disorder. Today, there are effective and safe treatments validated by health authorities. It is therefore not necessary to “live with it” without a solution.
As soon as sweating is moderate to severe and impacts quality of life, medical management is recommended. Treatment depends on several factors : the affected area (armpits, hands, feet, face), the intensity of symptoms, and the specific needs of the patient.
The most widely used treatment remains botulinum toxin, especially for the armpits. This treatment, well known in medicine, temporarily blocks the activity of the sweat glands. It is recognized for its effectiveness, with visible results in just a few days and good tolerance.
Among the testimonies collected during consultations, the relief provided by Botox injections is undeniable. Patients report a clear improvement, often from the very first session. Those who benefit from it note :
A typical feedback is “Before the treatment, I used to change my shirt three times a day. I avoided light colors. Since the injections, I feel free. I don’t think about it anymore. It’s a radical change.”
This type of testimony is common, especially for people suffering from axillary hyperhidrosis, for whom the effect of Botox is both visible, rapid, and long-lasting (6 months on average).
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.
One of the aspects regularly discussed during consultations is the fear of side effects, particularly regarding botulinum toxin injections. Before starting treatment, some patients express concerns : pain during the procedure, local reactions, or effects on sweating in other parts of the body.
In practice, the injections are minimally painful : they are performed with very fine needles, into the dermis, without reaching the muscle. When local anesthesia is necessary (especially for hands or feet), it is applied as a cream or ice, making the procedure largely tolerable. Patients most often report a slight tingling sensation, sometimes a small tension, but rarely significant pain.
Regarding side effects, opinions are generally reassuring. In the vast majority of cases, no complications are reported. These adverse effects are temporary : a small bruise at the injection site, a sensation of muscle tension in the treated area, and more rarely, temporary weakness.
Doctors emphasize one point : adherence to proper technique is essential. When performed by an experienced practitioner, the treatment is safe and side effects remain exceptional.
As for compensatory sweating (sweating that would appear elsewhere on the body after blocking a zone), it does not occur with Botox. This phenomenon, well known after certain surgical interventions, is not observed with the injections. Patients confirm after treatment that they have not noticed an increase in sweat in other areas.
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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