Botulotoxin — Hyperhidrosis (Excessive Sweating) Treatment

Primary hyperhidrosis is a condition of excessive sweating beyond what is needed for thermoregulation — affecting approximately 1–3% of the population — and is driven by overactivity of the eccrine sweat glands under neural stimulation. The underarms, palms and soles are the most commonly affected zones. Social and professional impact is significant: many patients avoid certain fabrics, avoid handshakes or limit social activities because of the condition.…

Botulotoxin — the same agent used for wrinkle relaxation — works for hyperhidrosis through a different but parallel mechanism: rather than blocking neuromuscular signalling to a skeletal muscle, it blocks the cholinergic nerve fibres that innervate eccrine sweat glands, preventing the neural trigger that initiates sweating. When injected across an active sweating zone, botulotoxin substantially reduces sweat output in those glands for the duration of its…

The clinical advantage of the approach at CLED is the pre-injection mapping step. The Minor iodine-starch test — also called the Minor sweating test — is a validated dermatological procedure: iodine solution is painted over the dry skin of the treatment zone and allowed to dry, then starch powder is dusted over it. Wherever active sweat reaches the surface, it dissolves the starch granules and reacts with the iodine to produce a deep blue-purple colour.…