Hyperhidrosis treatment in London
Hyperhidrosis, or excessive sweating is a common and under diagnosed condition which involves the secretion of sweat that exceeds the normal production by the body. The impact on quality of life can be enormous. One of the most commonly affected sites are the armpits in both men and women. Hyperhidrosis can be classified as primary or secondary depending on if a specific cause can be found for the excessive sweating. The vast majority of cases are primary with no underlying cause. While sweating is a normal bodily function, some people will suffer excessively, and it will impact their day to day life. You may notice you have to change clothing throughout the day, or it may be impacting on your self-esteem and confidence.
Hyperhidrosis can also be categorised into focal (localised to a specific area) or more generalised affecting the whole body.
Hyperhidrosis Diagnosis Criteria (2 for a diagnosis of hyperhidrosis)
- Excessive sweating that lasts for more than six months with frequent exacerbations
- Excessive sweating affecting both sides of armpits
- Family history of hyperhidrosis or excessive sweating
- Symptoms started at a younger age (<25)
- No significant sweating while asleep
- Impairment of activities of daily living
- Hyperhidrosis affecting the armpits, palms or soles
Centre for Surgery is a specialist centre for excessive armpit sweating and offer a unique multidisciplinary approach to the treatment of this potentially disabling condition.
- Botulinum toxin type A
- Morpheus8 Fractional RF microneedling
- Axillary suction-curettage
Expected results after excessive sweating treatment
- Significantly reduced levels of sweat production
- Improvement in confidence leading to improved personal and professional relationships
RealSelf Top Doctors
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Why choose Centre for Surgery for hyperhidrosis treatment?
- Over 15 years experience with all types of hyperhidrosis procedures – neuromodulator, suction-curettage and fractional RF microneedling (Morpheus8)
- We regularly receive patients from overseas at our plastic and cosmetic surgery specialist centre
- We own and manage our own surgical facilities. Properly performed hyperhidrosis treatment takes time and should not be rushed.
Our surgeons are full members of:
What is hyperhidrosis or excessive sweating?
Hyperhidrosis also known as excessive sweating is a condition of overproduction of sweat by sweat glands that is more than required to maintain the body’s normal temperature. Hyperhidrosis is not always related to being in a hot environment or exercise. Hyperhidrosis can be a very socially disabling condition with patients constantly having to change their clothing or wipe their palms dry. There is increasing awareness of hyperhidrosis as more effective treatments become available. Excessive sweating can markedly impair quality of life through interference with doing a job, personal relationships and confidence levels.
Centre for Surgery offer three highly effective treatment options for excessive sweating:
- Botulinum toxin type A (temporary treatment – non-surgical)
- Fractional RF microneedling (permanent but needs to be repeated in patients with high BMI)
- Axillary suction-curettage (permanent treatment – surgical)
While sweating is a normal body physiological function, some people naturally sweat more or less than others. Those individuals who sweat excessively can cause problems and embarrassment with school, work and social situation.
Hyperhidrosis affects both males and females and can start at any age. Hyperhidrosis may be localised or generalised. Body parts such as armpits, hands, feet and groin tend to perspire more due to a high concentration of sweat glands in these areas.
If excessive sweating is limited to these areas it is called localised or primary hyperhidrosis. If the whole body perspires excessively it is called generalised or secondary hyperhidrosis, and this is usually caused by a systemic condition for example hyperthyroidism (an overactive thyroid gland). Excessive armpit sweating may also lead to a large variety of secondary medical conditions such as bacterial or fungal overgrowth, muscle cramps, eczematous dermatitis, among others. Up to two thirds of patients report a positive family history, which suggests that a genetic predisposition may exist.
Hyperhidrosis can be effectively controlled or treated now with anti-wrinkle injections as a temporary treatment required one or twice a year or with the minimally invasive procedures of Morpheus8 RF microneedling and suction curettage.
Ideal candidates for hyperhidrosis treatment
Centre for Surgery does not offer procedures to those under the age of 18. You will need to have realistic expectations of what this procedure can achieve.
You will need to attend a consultation with one of our dermatologists before undergoing this treatment. They will be able to assess whether you are a suitable candidate for this procedure. You should be in good health and for the surgical options and you will be assessed by a dermatologist to make sure there no factors that could adversely impact on wound healing. This disorder can occur at any stage of life. However, the average age at the time of onset of the condition depends on the site involved. Excessive armpit sweating onset usually occurs during the teenage years.
A good candidate for hyperhidrosis treatment:
- You experience moderate to severe sweating of the armpit, palms or soles
- Deodorants or antiperspirants do not reduce the level of sweating
- You are willing to have regular injections of Botulinum toxin type A every six months to maintain the results
The starch-iodine test is an objective way to assess the extent and distribution of the disease. However, the test does not provide any indication of the severity of the condition. It is often used to measure the success of any treatment option when carried out between 6 to 12 months after treatment.
Hyperhidrosis treatment methods
Deodorants and anti-perspirants are the most common solution for excessive sweating of the armpits. Deodorants are not effective for excessive sweating of the palms or soles. Even the strongest deodorants and anti-perspirants are often ineffective for excessive sweating. Deodorants and anti-perspirants are only short-acting and would need many applications throughout the day to adequately control excessive sweating.
Severe underarm sweating is a medical condition involving overactive sweat glands. While sweating is a way your body regulates your temperature, excessive sweating far exceeds the body’s need for cooling.
Patients with excessive sweating:
- Change clothes frequently
- Put absorbent material under clothing
- Avoid certain types of fabrics and styles of clothes
Centre for Surgery in London are one of the few centres to specialise in both non-surgical and minimally invasive surgical methods to treat hyperhidrosis of the armpits. The use of neuromodulator injections for treatment of hyperhidrosis is one of the most commonly used methods as it is non-surgical in nature. Neuromodulators are also known as anti wrinkle injections and are most commonly used to treat facial lines and wrinkles. Neuromodulators act on the nerves supplying the sweat glands to reduce sweat gland production. Neuromodulator injections can result in up to six months of being symptom-free and about 50-100 units of neurotoxin are required for each armpit area. Excessive armpit treatment usually requires 2-3 sessions of neuromodulator per year.
Botulinum toxin type A
Excessive sweating, or hyperhidrosis, can be treated effectively with neuromodulator injections. The injections have been used to completely reduce or resolve excessive sweating.
Many patients have tried prescription antiperspirants without success, and for those patients, injections are a viable treatment. Local anaesthetic numbing cream is first applied to both armpits. The injection is injected into the affected areas in a grid-like pattern and works by blocking the chemical signals from the nerves that stimulate the sweat glands. When the sweat glands don’t receive chemical signals, the severe sweating stops. Sweat does continue to be produced in other areas of your body.
In addition to the armpit area, anti-wrinkle injections can be used to treat excessive sweating in the palms and soles of the feet as well. To determine if injections are right for your type of excessive sweating, schedule a consultation with one of our surgeons.
Patients increasingly desire a safe and effective procedure with a favourable risk profile, low complication rates and that keeps them the shortest possible time away from daily activities. Local surgical treatment of axillary hyperhidrosis aims at eliminating the largest possible number of sweat glands in the armpit region, while preserving, as much as possible, the normal aesthetic appearance of the armpit and mobility of the arm.
Axillary suction curettage is a minimally invasive surgical option for highly effective treatment of axillary hyperhidrosis. In this procedure, the sweat glands are permanently destroyed before being curetted out with a specially designed surgical curette. It is often not possible to remove 100% of the sweat glands although the amount of sweat glands surgically removed is often enough to ensure a significant and permanent reduction in sweat production. This procedure is most commonly performed under a local anaesthetic as an outpatient procedure which means you will be admitted and discharged on the same day. The procedure is very well tolerated with little to no pain or discomfort during and after the procedure and there is no requirement for general anaesthetic, but as with all procedures at Centre for Surgery, the choice of tablet oral sedation or even TIVA general anaesthesia is available if you feel very anxious about being fully awake during the procedure.
The first step involves injecting the area with a solution containing a local anaesthetic and a vasoconstrictor. This minimises the risk of feeling any pain and discomfort, as well as any risk of bleeding. This procedure involves locating where the sweat glands are. Next, a small incision is made and power-assisted suction curettage is undertaken to permanently disrupt and remove sweat glands. This method avoids any damage to the connective tissue framework and blood vessels. A small curette shaped cannula is then used to remove the undersurface of the sweat glands. Finally, the remaining layer of fat is equalised with cannula probes to minimise any unevenness. This allows you to have a smooth appearance without any lumps or rippling skin that can occur with traditional methods of liposuction. Suction curettage is a much safer technique when compared with laser assisted methods which carry a additional risk of causing localised skin burns.
This method is much gentler and effective than traditional older techniques carried out under general anaesthetic. The scar burden is minimal and the recovery period is quick. You will only have to undergo one treatment, as the glands will have been physically removed and do not grow back after treatment.
Morpheus8 for hyperhidrosis
Whilst neuromodulator injections and surgical treatment with suction-curettage are established treatments with a great record of safety and effectiveness, both treatments have their downsides. With neuromodulator injections, only a temporary effect is possible which lasts up to 6 months. Although suction-curettage is a more permanent treatment, there are risks attached as it is a more invasive surgical procedure. The most exciting prospect for hyperhidrosis treatment is the use of fractional radiofrequency microneedling. The Morpheus8 device is the latest generation of fractional RF microneedling with full control over needle depth adjustment and the level of energy delivered through the 24 precision microneedles.
The tiny pins of the morpheus8 device are able to penetrate deep enough into the skin to impart controlled thermal energy via the micropins to precisely ablate the sweat glands. The Morpheus8 procedure for excessive armpit sweating does no require any incisions and leaves no scars. The procedure can be performed effectively with the prior application of topical local anaesthetic cream to permit a pain-free procedure. Two treatments are ideal for permanent treatment effects, and in those with more severe grades of hyperhidrosis, three treatments are recommended for best results.
Recovery after hyperhidrosis treatment
The recovery period will vary depending on which option you chose to undertake. Neuromodulator injections will have no downtime. In some rare cases, you may notice some bruising or swelling at the injection site, but this will fade with time.
If you undergo Morpheus8 microneedling, you may notice an area of localised redness that will persist for a couple of days but again no downtime is usual.
You may notice some swelling, numbness or tenderness with suction-curettage treatment, which will last around one week. You can usually return to normal activities within 2 weeks but this will depend on the surgical postoperative instructions given to you by your surgeon.
Hyperhidrosis treatment before and after
Risks and potential complications of hyperhidrosis treatment
Complications can potentially occur with any surgical procedure, suction curettage for hyperhidrosis is no different. At consultation, your surgeon will always take time to fully discuss the risks and complications associated with hyperhidrosis treatment. All risks will be outlined regardless of how rare they are. By choosing Centre for Surgery for your hyperhidrosis treatment, you can be confident in having highly experienced and expert dermatolgists to perform your procedure.
Although the minimally invasive suction curettage technique has shown to have a low complication rate, a variety of mild to moderate side effects (for the most part, temporary) has been reported.
Possible complications of suction curettage for hyperhidrosis include:
- superficial erosions of the skin
- Loss of local sensitivity
- Skin necrosis
- Reduction in the number of hairs
- Formation of subcutaneous adherences
- Recurrence of hyperhidrosis (rare)
How to find us
Centre for Surgery is located at 106 Crawford Street in Marylebone. Crawford Street is just off Baker Street. We are easily accessible by all major bus routes that pass through Baker Street as well as Baker Street underground station.
From the tube station, we are just a 5 minute walk southwards down Baker Street followed by a right turn onto Crawford Street. The clinic is about 200 yards on the left.
There is ample local pay & display parking in the surrounding area and an NCP car park is located further west along Crawford Street. Our local residential parking zone is the City of Westminster.
Address: 106 Crawford Street, Marylebone, London, W1H 2HY
What is hyperhidrosis?Excessive sweating also known as primary hyperhidrosis is a relatively common problem affecting men and women of all ages. The condition is characterised by the excessive production of sweat that is more than what the body requires to maintain internal body temperatures.
Typically affected areas of excessive sweating include:
- Underarms or armpits
- Palms of the hand
- Soles of the feet
There are a number of other areas that can be affected by excessive sweating including the upper part of the face, the groin region, below the breasts in the inferior breast fold and that scalp.
Hyperhidrosis is not known to be a dangerous condition but it can be very distressing for sufferers of the condition. It is associated with an increased risk of developing other conditions of the skin such as skin infections which include both bacterial and fungal types and also an increased risk of developing warts or verrucas.
Sufferers can be affected in both there home and work environment and manifests in a number of ways including:
- Moist sweaty hands which makes people avoid handshakes
- Visibly stained clothing
- Manual tasks that require dry hands are difficult
- Localised skin irritation due to excessive sweating production
- Increased risk of developing bacterial or fungal skin infections
Is hyperhidrosis hereditary?There is no strong link between hereditary factors and the development of excessive sweating. Hyperhidrosis or excessive sweating is a very common condition that affects up to 5% of the UK population.
Is hyperhidrosis a dangerous condition?Hyperhidrosis is not known to be a condition which is linked to anything more sinister.
There is also no scientific evidence to demonstrate a strong link between the development of dehydration from those who suffer from excessive sweating.
However excessive sweating can still have an enormous impact upon self-confidence and can affect one's normal daily activities leading in some cases to psychological impact.
How can excessive sweating be prevented?Patients with excessive sweating should consult with an expert dermatologist in the first instance for a full medical assessment. In addition to medical treatment, your dermatologist may recommend all of the below to help in symptom control;
- Avoid deodorant and use powerful antiperspirant.
- Wear mainly cotton and loose fitting clothes
- Use protective sweat shields to avoid clothing becoming soiled
- Where 100% cotton socks for effective absorption of excessive
sweating and make sure to change socks up to 3 times a day
- egularly change your footwear and preferably wear leather shoes
- Avoid spicy food or alcohol which are both known to increase hyperhidrosis
What treatments for excessive sweating are available at Centre for Surgery?At Centre for Surgery, our dermatologists are expert in the full range of treatments for hyperhidrosis including both nonsurgical and surgical techniques.
- Botulinum toxin type A is a very commonly used nonsurgical treatment for injection into the armpit. This is a powerful neurotoxin which functions by blocking nerve signals to the sweat glands. The result is a significant reduction in sweat production. This is a temporary treatment and continued reduction in excessive sweating must be maintained with regular injections of botulinum toxin.
- Radio frequency microneedling also known as Morpheus8 is a highly effective treatment for hyperhidrosis without the requirement for more invasive surgical treatment. With up to 3 treatments of Morpheus8, hyperhidrosis can be effectively treated often with permanent results.
- Suction curettage is a minimally invasive surgical treatment for excessive armpit sweating also known as axillary hyperhidrosis. Treatment is easily and comfortably performed under local anaesthetic as an outpatient. Even very severe grades of hyperhidrosis can be effectively treated with permanent results.
Will hyperhidrosis go away on its own without treatment?In a small number of cases excessive sweating does occasionally improve with time but this is very rare. Most cases of hyperhidrosis either remain the same in symptom severity or may get worse over time.
How many treatments of RF microneedling are needed for hyperhidrosis treatment?RF micro needling also known as Morpheus8 is a highly effective nonsurgical treatment using a combination of fractional micro needling combined with specially designed radio-frequency insulated micro needles for the treatment of all grades of hyperhidrosis.
Up to 3 treatments may be required although in many cases patients may notice complete resolution after only two treatments. Treatments should be carried out at four weekly intervals.
What results can be expected from treatment for excessive sweating?With the full range of treatments for hyperhidrosis being offered at Centre for Surgery, patients can achieve excellent outcomes based on their goals for treatment and what level of downtime they are prepared to accept.
The use of botulinum toxin type A for excessive sweating result in a significant improvement in symptoms lasting between 6 and 12 months, following which it may be necessary to have further top up treatment to maintain the results.
Both Morpheus8 RF microneedling and surgical suction curettage are permanent treatments for primary axillary hyperhidrosis
How do botulinum toxin injections help reduce excessive sweating?The injections works by blocking the chemical signals from the nerves that stimulate the sweat glands. When the sweat glands don’t receive the chemical signals, the production of sweat stops.
The use of botulinum toxin type A for the treatment of excessive sweating has been revolutionary. A single treatment can lead to complete relief from excessive sweating symptoms for at least six months. The mechanism of action by which botulinum toxin type A eliminates sweating has been known for a number of years but it is only over the last 20 years or so that it’s established use in the treatment of excessive sweating has become more accepted.
The treatment is very straightforward to carry out and takes no more than 20 to 40 minutes to perform depending on the area treated and the risk of complications is very minimal.
How does Morpheus8 reduce excessive sweating?The specially coated needles penetrate deep into the layer of skin containing the sweat glands. Precise application of radiofrequency energy ablates the sweat glands
What are the benefits of suction curettage for primary axillary hyperhidrosis?Suction curettage is a minimally invasive surgical treatment for axillary hyperhidrosis and is easily carried out as an outpatient under local anaesthesia for permanent relief of symptoms from excessive sweating. The treatment targets the underlying sweat glands by physically disrupting them followed by their removal using small suction curettes placed beneath the skin. There is very little if any scarring with a very quick recovery time and with minimal risk of complications when performed by one of our expert dermatologist or plastic surgeons.
Suction curettage is a one and done treatment with no requirement for further treatments unlike injections of botulinum toxin type A or fractional RF microneedling also known as Morpheus8.
Does excessive sweating treatment hurt?All types of treatment for excessive sweating are very well tolerated under either a topical local anaesthetic cream or the injection of local anaesthetic into the armpits. In most cases it is not necessary to have painkillers after the procedure.
For axillary suction-curettage, you may wish to combine the injection of local anaesthetic with mild oral tablets sedation to make you more relaxed for the procedure.
Is there any downtime after excessive sweating treatment?Injections of botulinum toxin type A or RF microneedling require no period of downtime and patients can return to normal activities straight away.
Treatment with axillary suction curettage may require a day or two off work at most. Suction curettage is a minimally invasive procedure with very little in the way of post-operative discomfort.
Is hyperhidrosis treatment permanent?The use of botulinum toxin for hyperhidrosis treatment is not a permanent treatment option. Treatment will need to be repeated after 6 to 12 months to maintain the results.
Morpheus8 RF micro needling and suction curettage are permanent methods of treatment for hyperhidrosis.
What other treatments are there for hyperhidrosis?Apart from non-invasive treatments for excessive sweating such as the use of prescription strengths antiperspirants there are a number of recognised in clinic medical treatments.
- Iontophoresis is a treatment for excessive sweating that makes use of an electrical current to reduce or eliminate sweating. It is mainly used for excessive sweating affecting the hands and feet and is challenging to use on other areas. The major disadvantage of iontophoresis is that it requires a number of repeated treatments and each treatment take a long time to carry out. The results of iontophoresis for the treatment of excessive sweating are variable and are not as affective as the treatments used at Centre for Surgery.
- Another treatment for hyperhidrosis is the use of the Miradry device. This device is a relatively new technique for the treatment off armpit excessive sweating. The cost for this treatment is relatively high as the equipment itself is expensive to purchase and there are still a number of doubts over the long term effectiveness of this type of treatment. With Miradry it is difficult to treat areas such as the palms of the hand or the soles of the feet and there is a very real risk of causing thermal injury or even burns to the skin.
- For patients who suffer from very severe cases of excessive sweating, there is the option of endoscopic thoracic sympathectomy or ETS. ETS is a highly invasive treatment which is carried out in hospital under general anaesthesia by a vascular surgeon and carries significant risks and potential for complications which can be permanent in nature.
Where is Centre for Surgery located?Centre for Surgery is located at 106 Crawford Street in Marylebone. Crawford Street is just off Baker Street.
Our address is 106 Crawford Street, Marylebone, London, W1H 2HY.
We are easily accessible by all major bus routes that pass through Baker Street as well as Baker Street underground station.
There is ample local pay & display parking in the surrounding area and an NCP car park is located further west along Crawford Street. Our local residential parking zone is the City of Westminster.
What To Expect
What to expect at your hyperhidrosis consultation
You will be booked in to see one of our expert dermatologists at Centre for Surgery on Crawford Street for your excessive sweating consultation.
The dermatologist will perform a thorough clinical examination of your skin and the areas of hyperhidrosis and will discuss a number of aspects with you:
- Treatment options based on the type of excessive sweating you have and what kind of results can be expected with the proposed hyperhidrosis treatment
- What the excessive sweating treatment involves
- Review your medical history including any medicines you be taking
- Answer your questions about any aspect of the excessive sweating treatment
Patient journey summary:
- Arrange a consultation at our dermatology clinic at 106 Crawford Street, Marylebone for a face to face consultation with an expert dermatologist
- Commence a course of treatment based on your needs and preferences
- Arrange a follow-up appointment if required to be seen by your dermatologist to review the effectiveness of treatment