Sweat odor and sweat stains aren’t pleasant for anyone. Who does not know them, the dark spots that are especially visible on white blouses or shirts in the underarm area? But not all people sweat the same – and not all people suffer equally.

What is primary hyperhidrosis?

Increased sweating can have various causes. Since sweating is often a symptom of disease or hormonal changes in the body, it is always a good idea to first investigate the cause before focusing on pure symptom treatment. If there is severe sweating in an otherwise healthy person, it is called primary hyperhidrosis. This can occur in various places, often on the soles (sweaty feet) or palms. Out of 100 people, about 1 to 5 people have primary hyperhidrosis.

In terms of health, this is absolutely harmless for those affected. However, some people find it massively stressful, so that their lives and social interaction are severely limited.

How does sweat smell develop?

When we sweat, not only the sweat glands, but also the adjacent olfactory glands secretion. If this mixture then comes into contact with bacteria on exiting, which are always on the surface of the skin, the familiar, unpleasant odor arises. Sweat production is controlled by our vegetative nervous system, by the parasympathetic nervous system. It is responsible for the automated processes in the body and can not actively influenced.

What treatments are available for excessive sweating?

The simplest and most common way to reduce sweating is deodorization. These may either contain minerals that prevent odor from occurring or they may temporarily block sweat glands to prevent segregation.

A popular component in deodorants, albeit less frequently, are aluminum salts. They are controversial because there is a suspicion that they can continue to migrate through the lymph channels in the body and sometimes trigger serious illnesses there. Here, the study situation is still quite thin. In other words, you do not know exactly. To be on the safe side, therefore, many deodorant manufacturers now do without aluminum additives, which in turn has another unfavorable side effect: the deodorants do not work so well.

How can the doctor help?

When deodorants are the mildest form of treatment, at the other end of the spectrum is the severing of the nerves that control the sweat glands. The laparoscopic intervention interrupts communication between parasympatikus and glands. For people who really sweat a lot, this is an effective option, but it is rarely done.

Another option is to aspirate the sweat glands. This works at least partially, the sweat production is weakened locally. However, it can not be completely prevented, as many sweat glands are located in the skin, and suction removal always removes only those that are located beneath the skin in the fatty tissue.

Sweat gland treatment with microwaves

A very young form of treatment is miraDry®. In this non-invasive procedure, the sweat glands are destroyed by microwaves, nothing happens to the surrounding tissue. Again, the effect is good, but the sweating is not completely prevented.

How does botulinum toxin work against perspiration?

Botulinum toxin (“Botox® or Bocouture®”) is used to inhibit the muscles of the sweat glands and the olfactory glands. As a result, they can no longer eject their secretions – resulting in a nearly 100% sweat reduction. Because it is a local treatment, the rest of the body – and thus the rest of the sweat production – remains unimpaired.

Sweat has an important excretory and detoxifying function for the body, and it also serves for our cooling and thermoregulation. The sweat in the armpit, however, accounts for only two percent of the total perspiration, so it is no problem for the body to give it up.

Do I sweat more in other places if I suppress perspiration locally?

Theoretically yes. In practice, the difference is imperceptible, since the mentioned 2% are distributed over the entire body surface.

What costs should I expect?

Depending on the size of the area treated, about € 590 – € 690.

This is, admittedly, somewhat costly, since a significantly larger amount of Botox is needed than with a facial. Beware of cheap providers: A strong price reduction can only be achieved by a strong dilution of the active ingredient – and thus by an equally strong “dilution” of the effect.