Hyperhindrosis-No Sweat!

In hot and sunny Singapore, it is normal to sweat, right?

Check out our New Article on Tablets to stop Sweating HERE. 


 

Yes, it is usually normal. Indeed, sweating is one of the most important ways that your body dissipates heat and regulate the body’s temperature. However, for a small minority of people, their body produces sweat in amounts far greater than what is needed for normal thermoregulation.

 

In most cases, this excessive sweating is often produced on relatively minor triggers like certain types of food or in social situations involving minor anxiety or strong emotions; In some people, the sweating reflex is even triggered inappropriately e.g. When feeling cold.

 

Medically this excessive sweating is termed as hyperhidrosis. Studies show that as many as 2-3% of the population suffer from this problem. Hyperhidrosis leaves patients constantly feeling wet or damp in certain parts of the body. Nowhere is this more embarrassing than having the telltale sweat marks on the clothing in the armpit area; Not to mention the possible odour that it causes.

 

To be sure, the sweat itself doesn’t produce the odour, but if the sweat remains in the armpits for a sufficient amount of time, bacteria eventually starts to work on the sweat and this produces the smell that we are all too familiar.

 

Most combat this problem using anti-perspirants, which have a long history, being invented more than a century ago. The active ingredient in such products are actually aluminum salts and now comes in many forms like aerosol sprays, creams, roll-ons and even crystals.

 

These work by interacting with the electrolytes in sweat to form a gel-like plug in the ducts of the sweat gland to prevent the sweat from reaching the surface of the skin. This is actually quite an elegant solution to the problem but this plug may not last long and gets sloughed off easily. In addition, its efficacy varies from person to person, working well for some people while being close to ineffective in others.

 

In particular, for people with hyperhindrosis or excessive sweating, anti-perspirants are only effective if used in high concentrations and in these concentrations, local skin irritation is common.

 

Nevertheless, anti-perspirants are easily available over-the-counter and is currently the most popular treatment for hyperhindrosis.

 

For patients whose sweating problems are more severe than what anti-perspirants can treat, or desire a more complete and lasting treatment, they can undergo a surgical procedure called endoscopic thoracic sympathectomy (ETS). This involves clamping or destroying the part of the nerve that controls sweating in the affected areas.

 

Being a surgical procedure, this involves some downtime for patients and some side effects are often reported. These side effects can range from trivial to some relatively debilitating. Oftentimes, there is compensatory sweating in areas that have not been treated, causing more sweating that what is usually experienced in other parts of the body.

 

Additionally, due to nerve regeneration, the procedure may not ensure a complete and permanent relief, with some patients reporting a recurrence of the sweating problem as early as 6 months post procedure.

 

For patients who are not keen for surgery, this is where BOTOX comes in.

 

As most are aware, BOTOX is the protein derived from toxin produced by certain bacteria which paralyses muscles, including those of the face to remove wrinkles.

 

What is less known however, is that this same protein is also useful in disabling sweat glands. This new indication for the use of BOTOX has been approved by the United States Food and Drug Administration just over 5 years ago.

 

This procedure involves first using a dye to highlight the areas that are producing excessive sweat in the armpits. Then, using a very fine needle, a series of injections are made in the offending areas. As the needle is very fine and only a small amount of fluid injected each time, pain is usually not an issue. There is also no downtime and normal activities can be resumed almost immediately post procedure.

 

The BOTOX works by interrupting the actions of the nerves that supply the sweat glands and hence, preventing the glands from producing sweat.

 

The sweating stops in more than 90% of patients less than a week after treatment with many reporting good results as early as a few days post injection. In rare cases, a top up may be needed to augment the effects if results are not satisfactory after the first procedure. Side effects from the procedure are usually minor, e.g. Mild swelling and erythema at the injection site. As the injections are very superficial, it does not affect the underly tissues like nerves and blood vessels. Moreover, the treatment is local, so there are no widespread side effects on the body.

 

For long suffering patients, this therapy is a delightful change, liberating them from the daily worries of sweating in the wrong place at the wrong time. Along with it, odour problems become a thing of the past.

 

Nevertheless, BOTOX is not a permanent cure for hyperhindrosis and the effects last anywhere from half a year to almost year (depending on individual patients) before starting to wear off slowly. When this happens, don’t worry, the treatment can be repeated… No sweat!


Need more advice?

Dr. Tan and Partners @Scotts (Skin and Aesthetics Clinic)

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79 Comments

  1. Samantha

    Good day,

    I’m suffering from sweaty feet and subsequently led to odour and the end of the day.

    May I knowthe estimate costs for Botox injection to treat exceeding sweating on my feet?

    Thank you!!

  2. cindy

    Hi, I am 20 years old I am not that type of person who sweat a lot ,or immediately after shower, but i have strong body odour even if i apply deodorant there’s still a smell but not as strong compared when i didn’t apply.

    do you have any treatment for sweat reduction or treat body odour treatment expect for botox. I heard that there’s miradry treament do you have this treatment?

    do you have any treatment that is permanent ? or no need to keep doing?
    any side effect? and how much does it cost?

  3. Hi Dr Tan,

    Im abby, and i have excessive sweating problem in my underarm for as long as i can remember, i tried home remedies and anti perspirant deodorant but it does’nt seem to work for me. Its very annoying that even after i shower my underarm is sweating already and even in a cool place or with aircon around it still sweat. Hope u can help me, i heard that underarm botox is effective, im just curious about the procedure, will it be per session or one time treatment? And how much it cost? Thank you for your time. Really appreciate if i could get my questions been answered. Thank you.

  4. Hi,

    I sweat excessively in my underarm even right after i shower. Im really having discomfort everytime i wear colored shirts couse you can see clearly how wet it is. How effective is botox injestion? And how much it is? Will it be per session? Thank you.

    • Hi there. Underarm botox injection for hyperhidrosis can effectively reduce sweating by up to 70-80% if you respond well to the treatment. Price is approximately $1000 – $1500. You will need to be assessed by a doctor so you can be advised better.
      You can call 62350338 to arrange an appointment if you wish to come in, or click HERE to contact us.

  5. Hi there,

    I basically cannot walk outside for more than 3 minutes without excessive sweating on my forehead and temples, in addition to my armpits, delts, back, chest and upper stomach area.

    The use of Dryclor pretty much solves the armpit and shoulder issue, so that is fine – and I can deal with having a sweaty back, however, the excessive sweating on my forehead is insane.

    Whilst I understand anxiety will likely make it worse – the issue I have is it just takes longer for me to acclimatise to a temperature change compared to most people. For example, if I walk into a warm room, where someone might get used to the increased temp after 20 mins or so, I am sweating constantly for an hour usually.

    My question is – whilst I cannot use Dryclor on my forehead – Could pills be prescribed to me to at least try and resolve the forehead issue?

    If so, can we visit any of your practices for this treatment, as the 11 Unity Street practice is the closest to me (just wanting to clarify, as it has been listed as an STD clinic)?

    Thanks in advance.

    • Based on your description, Oral anti-sweating pills is a good option for you. It is only available at our branch at Scotts Road.
      Address: 9, Scotts Road, #06-06, Pacific Plaza, Singapore 228210.

  6. Hi Dr Tan,

    May I know approximately how much is botox treatment for the face area?

    Thanks

  7. Do Polyclinic provides treatment for sweat palms and feets?

    • We do not know. You should go visit the polyclinic. I’m sure if they do not do it, they can refer someone to you that does.

  8. darren

    Hi doc,

    i have undergo the ETS surgery about 8 months ago and the sweating have return on my right hand, although it is just mild for now.

    I am wondering if i will still be suitable to go for botox treatment after i have undergo ETS surgery before?

    i have quite a big hand, how much do you think it will roughly cause for me to do it on just my right hand?

    regards,
    Darren

  9. Hi Doc,

    I am suffering with an excessive sweat in my underarms. I heard that a laser sweat ablation treatment may reduce the sweat permanently. Is this true? What is the price range for the laser sweat ablation and how long will this last? Will there be any side effects?

    Thank you!

    Rgds,
    RM

    • Unfortunately, we do not provide laser sweat ablation treatment. However, we do provide oral medication and botox treatment for hyperhidrosis. Botox treatment is one of the best methods to control underarm hyperhidrosis.

  10. Hi, I sweat a lot on my scalp whenever I eat spicy food. The food doesnt have to be really spicy, I’ll still sweat. And its only on my scalp. Do you know why that is so? And will botox injection on the scalp work for this?

  11. Hi doc. Would like to ask what is the price range like for botox injections for my underarms. And how long will it last

    • It depends on the area to the treated and hence the number of units to be used. It can range between $750 to $1500 (total for BOTH sides). It usually lasts 4 to 6 months.

    • nurul

      Dr Tan…
      I am suffering from hyperdrosis.. I need help… I feel soo demoralised to even mix wif people because everytime i sit or chat wif people.. They will neither keep on rubbing their nose it affect me badly and i feel soo not motivated to even meet people..i am 26 years living in singapore.. I even try lemon home remedies.. Shower,deoderant,antiperspirant spray still my armpit sweat and even produced strong body odour.. I even google to purchased a machine name electro-anti perspirant from oversea.. It reduce the sweat but after a while the swear appear again..i purchased that abt $2000 singapore dollar..as i use the machine my skin become sensitive develop rashes or even burn the skin and develop scar after that.. So now i badly need ur help on how to get rid of my sweat plus my body odour .. Pls dr tan.. Help me…

  12. How can I get rid of a serious BO? I don’t sweat accessively. I do take regular shower and as many as 4 times just to get rid of the BO. After coming out of shower i can start to smell myself. How can you help me.

    Thank

    • There are many possible reasons for BO. One of the easier ones to get rid of is a bacterial overgrowth. Try scrubbing yourself down head to toe with an anti-bacterial soap containing Chlorhexidine. Do this 2x per week. After every shower, cover yourself with a medicated talc. This reduces moisture on your skin and reduces bacterial growth.

  13. hi doc,i have a sweaty scalp may i know how much will it cost for oral tablet?thank you

  14. Hi,

    I used to sweat excessively on my hands, underarms and feet ever since I was in secondary school. Does it trigger when puberty starts? However, I have been using Driclor on my underarms and it feels like im still sweating but at least its not visible on my clothes anymore.

    Would like to know if there’s any reported cases of side effects from using the BOTOX treatment on sweaty palms?

    Does the treatment result in compensatory sweating in other areas as I know ETS does have rare cases of that happening.

    • Botox treatment for sweaty palms is painful and temporary. And yes there have been reports of compensatory sweating.

  15. Dr, have you ever prescribed iontopheresis for sweaty hands and/or feet and what has been the results?

  16. Hi doc, may I know what treatments are available for excessive sweating on the scalp area. Anti perspirants roll ons/ sprays are not useful for me (may be due to presence of hair). Will Botox be a possible treatment?

    • Excessive sweating on scalp area can be treated either by Botox injection or oral tablets. Scalp area may require quite a large amount of Botox to be effective.
      You are welcomed to visit us at our clinics to have a discussion.

  17. Hi doctor,

    I would like to ask a few questions, hopefully you’re abke to give me the answers.

    I sweat way too excessively during any sorts of exertion like sports or even just walking for like 10mins. But however, my main concern is that my palms just keep sweating no matter what. How effective can the Botox treatment be for my palms? And how much does it require to get the treatment done on both hands? Lastly, I understand that this treatment is only temporary but how about long does the effect last? Because to be honest the price is a major concern to me as this is a long term kind of treatment. Hope you are able to understand my point of view. Thank you very much!

    • Botox treatment for sweaty palms is effective. Cost depends on the size of your palms. You may require about 40-60 units of Botox on each palm (about 80-120 units in total). Cost of Botox is $15 per unit, therefore approximately $1200-$1800 for both palms. It is best to come in to talk to us so we can explain the procedure in details including side effects etc. Botox typically lasts for about 6 to 12 months.

  18. Roland

    Hi doctor tan

    Just a 2-4 mins walk I will be sweating like very badly ,my face , back , arms will be cover in sweat
    I know sweating is releasing heat from the body but I think Im sweating way too much . May I know whether is there any cure for my condition ?

    • Yes, there are several ways we can reduce excessive sweating. You are welcomed to visit us at any of our clinics to know more. We need to do a proper assessment of your health as well, so we can recommend the best treatment for you.

  19. matthew

    hi Dr Tan, i have excessive sweaty palms and i am considering to undergo a sympathectomy. around how much will the cost come to ?

    • We do not provide that service so I honestly do not know. You might want to check with a surgeon who does do this surgery. For cost management the best thing to do is to go through the polyclinic (I am assuming you are Singaporean and living in Singapore).

  20. Hi doctor,

    It there a way to cure compensatory sweating on the chest and back area?
    I did my ETS 3 months ago.

  21. Hi doctor tan,
    . I just asking how much botox for my hyperhidrosis for my both feet.im from the phillipines i planning visiting in singapore for check up
    i try botox for my feet if im arrive there and for my sweaty hands i want ionthoporesis this machine i can bringging here my country.
    thanks and god bless

  22. Andrealle

    Dear DR TAN,

    I been having sweaty armpit problem since my puberty. And even though i put on anti deodorant and i shave my hair weekly, it still sweat like mad and smell as well. I’ve researched that Laser Sweat Ablation works. But is this Laser Sweat Ablation effective and permanent? Any side effect? And will BOTOX be a better choice as compared to Laser Sweat Ablation? Thanks for your advice.

    • Laser Sweat Ablation is a procedure where the doctor uses a laser to destroy the sweat glands under your skin. It is potentially permanent in 70% to 80% of people. As with any minor surgical procedure, there is the risk of bleeding and infection but it is generally safe. I do not think one technique is definitely better than the other. I think you need to assess your needs with the pros and cons and make a decision.

  23. Hi Dr Tan , i’m having this problem since young which is sweating on my face even when i’m in the aircon room or doing nothing . Is there any way to treat it ? Like antiperspirant ?

  24. hello, How much to for face botox?

  25. Hi, may I know the price range for feet and armpit botox?

    • We do not treat the feet. For armpit most people will use a total of 100 units and that will cost $1500.

  26. Hi Dr Tan,

    I’m suffering hyperhidrosis on my armpit and want to do Botox, I just want to know how much will it cost? is it safe and painless?

    • Depends on how many units you need. Max 100 units which will cost $1500. It is safe but not painless.

      • Can a person become immune to botox in the axillary? It seems like botox is not working for me. What do u recommend? Would the procedure terminate with this problem for good. I am beyond tired dealing with this problem with unsuccessful results. Pls help. Do u think I am a good candidate for this laser procedure? If so, how much is this procedure? ? Thanks

        • Dr Justin Sim

          You won’t become immune to botox injections. Each injection should still produce a good effect. The only thing that diminishes the effect is not using a fresh or chilled sample of botox. Additionally this is still only a short term fix as once it wears off your symptoms will return. There is no way to get around this save extreme nerve surgery which will stop the sweating. However, this is not reversible and will also affect other nerve functions so is only seen as a very extreme last resort. Laser procedure will not be so useful for sweating axillary. It is only good for skin blemishes and such

  27. sweaty girl

    Hi Dr. Tan,

    Im 38 years old and currently suffering from sweaty palms, feet and armpits. I’ve noticed a severe sweating after I gave birth to my daughter. Hence, it’s giving me a hard time taking care of my baby. I cannot hold her for long because my palms will start to sweat. I always wear dark color and bring jacket to hide wet patches in my clothes. I cannot queue to register my fingerprints in the Immigration Automated Clearance System because the machine will not read my prints clearly. I love outdoor but I cannot enjoy it especially during sunny weather due to fear of sweating.

    It’s so troublesome and depressing because of this condition. I’ve read a lot of information about Hyperhidrosis and want to treat it permanently.

    So here’s my question, can I opt first for Subdermal Laser to treat my sweaty armpits? Then I’ll go for Video Endoscopic Sympathectomy to treat my sweaty palms and feet after I save enough money for the operation? Or Video Endoscopic Sympathectomy will treat the 3 (hands, feet, armpits)?

    • Here’s my 2 cents worth. I do not think Subdermal Lasers work very well. Sympathectomy only works for the palms. However, one of the potential side effects of sympathectomy is that your armpits starts to sweat more. As far as I know, there isn’t any current good effective treatments for sweaty feet. Not what you want to hear I know however, I am not a surgeon. You should speak to a surgeon who does sympathectomies and get his opinion on this.

  28. Hi dr tan,

    Im 20 this year and I’ve had genetic body odour from my armpits since young. It has always been a social problem to me and have affected me psychological when I was younger. 6 years old, I discovered perspireX and have been using it ever since. It did a great job in keeping the odour in discretion. However, once I stop using it, the odour comes back. I understand sweat itself have no smell at all. It’s the bacteria presence on my armpit skin that’s causing the problem. Other than the armpit area, I have no sweaty palms or other areas. because I’ve relied too much on the deodorant, it made my skin really sensitive and itchy. I really want to stop using the product and seek for a permanent cure. However, ard 5 years back, I went to see a dermatologist and he said that the surgical procedure is more suitable for people with sweaty palms and that there’s no procedure for armpits only at the point of time. I understand that there’s a lipo surgery overseas to deal with my problem, but it’s not available at all in sg. what I asked the doc was 5 years old ago.. Is it still the same for now? Can I undergo ets jus for
    My armpits only? I really wna get over this. Thanks in advance

    • Hi Mandy,

      You have obviously been doing your research and I agree with everything you have said. There is really no permanent way of stopping sweat production in the armpits. You can try to control the bacterial load first with antibacterial soaps and antibacterial powders. Doing permanent hair removal can also help reduce the bacterial load. Then there is Botox to control the sweating. This is also temporary and not a permanent cure. I suggest you try this first – wash your armpits daily with Chlorhexidine soap (availble at any pharmacy) and use Ammens medicated powder. After a week, the odour should be gone. Hopefully.

      rgds

      Dr Tan

  29. Hi Dr Tan
    运动把身体里面的脂肪燃烧了,让自己瘦下来会不会减少流汗?
    Thanks.

  30. Hi Dr Tan. Would like to check with you about botox for excessive sweating. After the injection say after 1 week can we resume doing exercise. And will i continue to sweat at the injected area when doing exercise or in a warm weather. If yes still sweating would it be excessive or reduced?

    • Hi Asmi,

      You can resume exercise 24 hours after the injection. Botox will reduce but not eliminate sweating. You will still sweat a little from the injected areas. Obviously the non-injected areas will continue to sweat.

      Rgds

      Dr Tan

  31. Hi Dr Tan,

    I’ve a problem which I’m not sure if it’s a medical condition. I have been doing street dance (attending dance classes) for about 6 years but since about 1 yr ago, I realised that I tend to perspire alot more than what I used to. Each time after I attended a class, my whole body would be drenched in sweat and I looked like I just bathe…. I understand that it is normal to sweat due to exercise but I think I’m sweating abit too much. How???

    • Hi Fion,

      Street dance just sounds so cool. There is really no such thing as sweating too much. From a physiological point of view, sweating is a very effective method of cooling the body. Our body automatically wants to maintain homeostasis (i.e. eveything stays the same), so as core body temperature rises, the body sweats to cool itself (loss of latent heat when sweat evaporates). Most people feel very good after a sweat and thinks it has cleansing properties. Either way, sweating when working out is actually a good thing. You really should not be concerned. At least not from a medical point of view.

      rgds

      Dr Tan

      • Hi Dr Tan,

        Thanks for the prompt reply! Appreciate much! Well, i do understand that it’s normal to sweat but it’s just that I hate it when my hair gets wet cus of my sweat and i’m unable to ‘whip’ my hair when i’m dancing. And I can’t really wear light colored bottoms to dance cus I’ll sweat so much that the sweat will ‘stain’ the bottoms and make me look like I wet my pants…. Quite disturbing =(

  32. Dear Dr Tan

    您说可以用boTok injection,那是不是三四个月没有流汗?用过Driclor,真的没有地方流汗,感觉很爽很凉,但是只耐一星期。有办法弄我背后流汗吗?不是我没realize,是真的一滴汗都不曾出,我每次有用手摸的。真的没有一个医生相信我说。失望:(

  33. Dear Dr Tan
    我就说您一定不相信。如果我说从我出生到现在一来没湿过您会相信吗?我赛跑也希望背后会湿,我每次很羡慕那些背后会流汗的人。等有一天我去星加破用走路或跑路去clinic找您您看了一定相信我,我的汗一出十再难停需要用冷气吹。有好医吗?我是不是怪胎?^o^

  34. Dear Dr Tan
    Can you believe my whole body NEVER sweat ? Only my face,neck sweat. If i exceedingly sweat on my face after running or in hot weather my face and neck will become Very Red and i felt very dizzy..See many skin speacialist Dr ,then he told me No medicine can stop sweat and he cannot believe my body never sweat. Have you come across patient like me?

    • Hi miao,

      That is strange. Sweat glands are found all over the body. It is more likely you sweat much more on your face and neck and not realize the small amount of sweat from your body. Doesn’t your T-shirt become wet after a run?

      rgds

      Dr Tan

  35. My face always sweat,I ever seen dr, the dr gave me driclor apply,only can last 1 week and start sweat after 1week. .very painfull when I apply driclor on my face. ..

    • Hi cindy,

      You can consider using Botox injections to control the sweating. Although the injections are also uncomfortable, at least it lasts for a few months.

      rgds

      Dr Tan

      • I’ve the exact same problem as cindy. I often sweat excessively on the face and neck area. It’s unsightly!

        Dr Tan: How ‘uncomfortable’ is the Botox injection? And what’s the price range like? Are there no other permanent solutions? 🙁

        • Hi Jo,

          I wish there was a permanent solution. If you come across something please share! Women usually take Botox injections very well. I have never come across a lady who complained Botox was painful. I must warn you that using Botox for the face and neck to reduce sweating is a little tricky. Because it might also affect the muscles underneath, we have to be careful with where we place the injections. So results may not be as dramatic as the same treatment for the armpits. Price range depends on how many units we need to use. A rough guide would be $300 for the face and $300 for the neck.

          rgds

          Dr Tan

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