Hyperhidrosis (Excessive Sweating)

When excessive sweating becomes a medical condition

Sweating is essential to life – it regulates body temperature. We only speak of hyperhidrosis when sweat production clearly exceeds the physiologically necessary level and occurs independently of warmth or physical exertion. Those affected avoid shaking hands, change their clothes several times a day, or can hardly pursue certain occupations. The strain is real and medically recognised – hyperhidrosis is not a question of poor hygiene.

Primary and secondary hyperhidrosis

In primary focal hyperhidrosis, individual areas – the underarms, palms, soles of the feet or face – sweat without any identifiable trigger. It usually begins in childhood or adolescence, occurs symmetrically and pauses during sleep. The secondary form is the consequence of another illness or of medication, often affects the whole body and also occurs at night.

We treat the primary form. If another cause lies behind it, that needs to be investigated first – through your GP.

Treatment with botulinum toxin

Botulinum toxin is the most effective method against focal hyperhidrosis. The active substance blocks the nerve impulses that drive the sweat glands. Injected into the underarms, it has been shown to reduce sweat production by 80 to 90 per cent, and to do so for six to nine months – considerably longer than in line and wrinkle treatment. We place a grid of fine injections just beneath the skin; the session takes about 20 to 30 minutes. On the palms and the soles of the feet the treatment is just as effective, but more sensitive – there we numb the area with cold, cream or a small nerve block.

How the botulinum toxin treatment works

After taking your history and explaining the procedure, we place the botulinum toxin in an even grid – for the underarms that means about 10 to 15 small injections per side with a very fine needle. You are presentable again straight away. The effect sets in after two to seven days, and the area stays largely dry for months. A follow-up check is included in the fee.

Who covers the cost

Botulinum toxin type A is licensed as a medicine for severe primary hyperhidrosis of the underarms where topical treatments have not helped sufficiently. Because this constitutes a recognised medical indication, private health insurers and civil servants' health assistance (Beihilfe) as a rule reimburse the treatment. You receive an invoice from us according to the German scale of medical fees (GOÄ) with the corresponding diagnosis, which you submit to your insurer.

We recommend submitting a cost estimate before the first session and obtaining confirmation in writing – the extent of reimbursement depends on your policy. Statutory health insurers, by contrast, do not cover the treatment; for patients with statutory health insurance it is a self-pay service.

Fees

Billing follows the German scale of medical fees (GOÄ); the cost of the preparation is included. As a medically indicated treatment the service is exempt from VAT. Private health insurers and Beihilfe usually reimburse the treatment; please clarify the extent with your insurer in advance. For patients with statutory health insurance it is a self-pay service.

Frequently asked questions