Hyperhidrosis Treatment (Botulinum Toxin for Excessive Sweating)

Botulinum toxin injected directly into sweat-gland-rich areas blocks the nerve signals that trigger excessive perspiration, offering 6–12 months of relief from hyperhidrosis (excessive sweating). Eva Clinic treats underarms, palms, and soles using a grid injection technique that distributes the toxin evenly across the target zone. Unlike prescription antiperspirants or oral medication, this approach acts locally on the eccrine sweat glands without systemic effects. MUDr. Chovančíková has been performing this procedure since 2009; results typically appear within days and last considerably longer than anti-wrinkle botulinum toxin due to the slower turnover of sweat gland nerve endings.

Hyperhidrosis — medically defined as sweating beyond what is physiologically necessary for thermoregulation — affects an estimated 2–3% of the population and can profoundly affect quality of life, causing social anxiety, clothing damage, and occupational interference. At Eva Clinic in Hradec Králové, MUDr. Chovančíková treats primary focal hyperhidrosis using botulinum toxin injections, a technique with robust clinical evidence and a well-established safety record. The mechanism: eccrine sweat glands are innervated by sympathetic cholinergic nerve fibres that release acetylcholine to stimulate secretion. Botulinum toxin injected intradermally blocks this acetylcholine release at the gland level, halting local sweat production. Unlike whole-body sweating, this effect is localised — other areas compensate minimally, and normal thermoregulation is preserved. The treatment session begins with identification of the hyperhidrotic zone using a starch-iodine (Minor's) test if needed, then a topical anaesthetic is applied for 30 minutes prior to injections in sensitive areas (palms, soles). MUDr. Chovančíková uses a grid-marking technique to ensure uniform distribution across the treatment area, typically placing injection points every 1–2 cm. For underarm treatment, between 15 and 25 injection points are placed per axilla; palmar treatment requires a regional nerve block for adequate comfort. Onset is typically visible within 3–5 days, with maximal effect at two weeks. The duration of effect in hyperhidrosis treatment is notably longer than for wrinkle relaxation — most underarm treatments last 6–9 months, with some clients reporting 10–12 months of dryness before requiring retreatment. This extended longevity reflects the slower regeneration rate of sweat gland neuromuscular junctions compared to facial expression muscles. The treatment is appropriate for axillary (underarm), palmar (palms), and plantar (soles) hyperhidrosis. Contraindications include neuromuscular junction disorders, anticoagulant therapy, active infection at the injection site, and pregnancy. Clients with secondary hyperhidrosis (caused by thyroid dysfunction, medication, or other medical conditions) should be assessed by their GP first to address underlying causes before considering cosmetic treatment.