Botulinum Toxin for Hyperhidrosis (Excessive Sweating)

Primary focal hyperhidrosis — excessive sweating localised to the armpits, palms, soles or forehead — affects an estimated 1–2% of the population and frequently causes significant social and professional distress. The condition results from overactive eccrine sweat glands controlled by the sympathetic nervous system via acetylcholine-releasing nerve terminals. Botulinum toxin injected precisely into the affected zone blocks acetylcholine release at these…

At DermaEsthetic MUDr. Hana Šulcová begins each session with a Minor's iodine–starch test (sweat mapping) to visualise the active sweat zones when indicated, then marks an injection grid over the treatment area. For the armpits, a standard grid spacing of approximately 1–2 cm is used across the hair-bearing zone; for the palms and soles — areas with significantly denser innervation — the grid is finer and local anaesthesia is offered as an optional extra…

The treatment session typically takes 30–45 minutes depending on the area and grid density. Results begin within three to five days as the toxin takes effect, reaching maximal dryness by two weeks. Efficacy lasts three to six months; with repeated treatments some patients find the interval extends as the chronic sweat gland hyperstimulation subsides. MUDr. Šulcová recommends a follow-up at two weeks to assess coverage and administer any touch-up…