About Focal Hyperhidrosis

love hands copyFocal hyperhidrosis is a major clinical problem, affecting more than 4% of the population. Below are some key points to guide you when treating this very challenging problem:

Focal Hyperhidrosis:

  1. Most commonly affects the hands, underarms, feet, and facial region.
  2. Frequently starts before the age of 25 and demonstrates a genetic predisposition.
  3. Often results in patients choosing careers in which they do not have to interact with people, shake hands, or give presentations.
  4. Can lead to emotional problems, including depression, poor self-esteem and social isolation.
  5. Is frequently called “The Silent Handicap”, as many patients suffer for years without seeking professional help.
  6. Can be controlled with non-medically supervised treatments like topical antiperspirants and iontopheresis in mild cases.

Medically supervised treatment options include MiraDry, Endoscopic Thoracic Sympathectomy (ETS) and Botulim Toxin injections.


A procedure which uses electromagnetic waves to induce thermolysis of the sweat glands.


  • Non-invasive, in-office procedure.
  • Permanent reduction of sweat by 85%.
  • Requires two 1-hr treatments, spaced 3 months apart.
  • Results in reduction of axillary hair density.
  • Effective against odor.
  • No long-term side effects.
  • Minimal to no downtime.


  • Not covered by OHIP.
  • Only approved for use in the axillae.


A surgical procedure to ablate a small segment of the thoracic sympathetic nerve. This procedure is often disregarded by many “Sweat Clinics” as too aggressive. However, in the appropriate patient, it can be life-changing.


  • Covered by OHIP
  • Permanent elimination of BOTH palmar and plantar hypherhidrosis.
  • Day procedure, with 4-6 days of downtime.
  • Two 5 mm incisions required.


  • Requires a general anesthetic.
  • 50% of patients will develop truncal compensatory hyperhidrosis, however in properly selected patients, it is mild and well tolerated.

Botulim Toxin injections:

BOTOX® injections temporarily block the chemical signals from the nerves that stimulate the sweat glands, which eliminates the production of excessive sweat in the treated areas.


  • Significantly reduces sweating.
  • Can be used in many areas of the body.
  • Performed in an office setting.
  • Very minimal side-effects and well tolerated.
  • Cost of Botox is covered by third-party insurance.


  • Effects typically last for 6-9 months.
  • Can be costly for patients without insurance.
  • When botox is injected in the hands, there is a very small possibility that patients may experience temporary weakness.

At the Toronto Sweat Clinic we customize care for the needs of the patient. While some clinics promote one treatment over the other, we recommend the treatment that best fits the needs of the patient, NOT the clinic!

Please visit us online at www.torontosweatclinic.com or call us at (416) 473-2252. We are happy to accept FAXED referrals at (905) 458-4080.