# Hyper*hidrosis.*

> Hyperhidrosis in the lexicon: primary and secondary forms, diagnosis, stepwise therapy from antiperspirant to botulinum toxin, procedure

- Source: https://www.vivaderm.de/lexicon-hyperhidrose-en.html
- Language: en
- Publisher: VIVA DERM, Privatpraxis für ästhetische Medizin, Rosastraße 6a, 45130 Essen, Germany, +49 1520 8367711
- Responsible physician: Katayoun Mostaghimi (Fachärztin für Allgemeinmedizin)
- Updated: 2026-10-05

Pathologically heavy sweating, usually of the armpits, hands or feet. Botulinum toxin blocks the sweat-gland nerves for several months.

## A closer look.

Hyperhidrosis is sweating beyond what is needed for temperature regulation. The primary form usually starts in adolescence, affects armpits, hands, feet or face and often runs in families; no cause can be identified. The secondary form results from illnesses, hormonal changes or medication and must be clarified first.

Treatment follows steps: antiperspirants with aluminium chloride, tap-water iontophoresis for hands and feet, then botulinum toxin, which interrupts the nerve impulses to the sweat glands for four to twelve months. For the armpits the substance is licensed; the effect starts after a few days.

For planning, an iodine-starch test can make the sweating area visible. Risks are low: small bruises, temporary compensatory sweating elsewhere, rarely a weakness of grip in the hands. As a medical diagnosis, reimbursement by private insurers is often possible.

This lexicon entry is general information and does not replace the medical consultation required under German law (§ 630e BGB).

## At a glance.

- **Form:** primary (usually) / secondary
- **First step:** antiperspirant
- **Botulinum toxin:** effective 4–12 months
- **Price:** from €500 (armpits)

## Frequently asked questions.

**Isn't sweating healthy?**

Yes – but hyperhidrosis is sweating without need that impairs daily life and work. Temperature regulation remains intact after treatment.

**How do I know if it is secondary?**

Sudden onset in adulthood, night-time or whole-body sweating are clues that should be clarified.

## Related pages.

- [Treat hyperhidrosis](https://www.vivaderm.de/hyperhidrosis-en.html) – Treatment
- [Understanding costs](https://www.vivaderm.de/guide-costs-en.html) – Guide
- [FAQ](https://www.vivaderm.de/faq-en.html) – FAQ

## Sources

- [NHS: Botox injections – patient information](https://www.nhs.uk/conditions/cosmetic-procedures/non-surgical-cosmetic-procedures/botox-injections/)
- [DGBT – German Society for Aesthetic Botulinum Toxin Therapy](https://www.dgbt.de/)
- [BfArM – Federal Institute for Drugs and Medical Devices](https://www.bfarm.de/)
- [European Medicines Agency (EMA)](https://www.ema.europa.eu/)
- [NHS: excessive sweating (hyperhidrosis)](https://www.nhs.uk/conditions/excessive-sweating-hyperhidrosis/)
- [§ 630e BGB – duty to inform before treatment (German Civil Code)](https://www.gesetze-im-internet.de/bgb/__630e.html)
- [AWMF – German clinical practice guidelines](https://www.awmf.org/)

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This page is general information and does not replace medical consultation and informed consent (§ 630e BGB). No guarantee of results. Prices are guide prices per GOÄ. Quoting with attribution (VIVA DERM, Essen) is expressly permitted.