Hyperhidrosis is excessive sweating, well beyond what the body needs to regulate itself. It most often affects the underarms, hands, feet or face. It is neither a lack of hygiene nor a fate. In Marrakech, Dr Sara Zahid, a dermatologist in Guéliz, starts by looking for the cause and gauging the impact, then offers a suitable treatment, from the simplest (antiperspirants) to Botox injections, which locally block the signal to the sweat glands and reduce sweating for several months. The session takes place at the clinic, without surgery, with a quick return to activities.
Sweating that goes beyond what is needed to regulate body temperature. It can be localised (underarms, palms, soles, face, scalp) or spread over the whole body. It shows as marked clothing, clammy hands when shaking hands or on a screen, damp feet, sometimes an odour linked to skin bacteria. When it interferes with social life, work or the choice of clothes, it deserves a consultation: it can be treated.
In the commonest form, called primary, sweating is excessive without an associated disease: it often begins in childhood or adolescence, affects specific areas symmetrically, sometimes runs in families and stops during sleep. It can also be secondary to a cause that needs looking for: thyroid problems, diabetes, menopause, infection, anxiety, certain medicines. New sweating that is generalised, nocturnal or accompanied by fever or weight loss must be reported without delay: tests are then needed before any treatment.
The consultation specifies the areas affected, age of onset, family history, medicines taken and the impact on daily life. An iodine-starch test (Minor test) may be done: it stains the skin where it sweats and draws exactly the area to treat, in the underarm for example. Depending on the context, blood tests may look for a secondary cause. This assessment allows the most useful treatment to be chosen, with no unnecessary care.
The first level is often an aluminium-salt antiperspirant, applied in the evening on dry skin; it can irritate and is adjusted with the dermatologist. For hands and feet, iontophoresis (a weak current in water) is an option. Some oral medicines reduce sweating but have side effects (dry mouth, for example). Surgical techniques exist, reserved for rare, selected cases, with possible side effects, notably sweating that moves to other areas. The choice is made together, according to the area, intensity and your preferences.
Injected into the skin, it locally blocks the nerve signal that controls the sweat glands: they produce much less sweat in the treated area. Sweating elsewhere in the body, which regulates heat, is not suppressed. Botox is a recognised indication in many countries for severe underarm hyperhidrosis; on the hands, feet or face, it can also be offered, after discussing benefits and drawbacks. The effect is temporary and reversible: it is a treatment to be renewed.
The underarms are the best-studied and most often treated area. Palms and soles can be treated too, with a more sensitive injection: suitable anaesthesia is provided, and a temporary drop in finger strength is possible in the hands. The forehead, face and scalp are treated with doses and points chosen to keep a natural face. Each area is discussed at the consultation: not all are treated in the same way or in the same session.
After marking the area (often with the iodine-starch test), the skin is cleaned, then the dermatologist makes many superficial, regularly spaced micro-injections with a very fine needle. An anaesthetic cream or skin cooling may be used. The session is short, without surgery or time off work. Afterwards, avoid rubbing the area, intense heat and physical effort on the same day.
The effect appears within a few days and is complete around two weeks. It lasts several months, often around six, varying from person to person. When sweating returns, the session can be repeated. A check-up consultation allows treatment to be adjusted if needed. Each person responds differently, which is precisely what the check-up is for.
The most common are pain at injection, small bruises or temporary tenderness. In the hands, temporary weakness of some muscles is possible. Treatment is avoided during pregnancy and breastfeeding, in case of neuromuscular disease, known allergy to the product or skin infection in the area, and certain medicines must be reported. In teenagers, local treatments are preferred first and Botox is discussed case by case. Risks and limits are explained before any decision.
At the Skin & Aesthetic Clinic, in Guéliz, with Dr Sara Zahid, dermatologist, by appointment, in French, English or Arabic. Marrakech's heat makes the problem worse: the session can be planned before the hot months. Patients from other Moroccan cities or abroad are also seen, with a first contact possible on WhatsApp.
Excessive sweating, well beyond the body's needs for regulation, localised (underarms, hands, feet, face) or generalised. It is not due to a lack of hygiene and can be treated.
Yes, it is a recognised treatment in many countries for severe underarm hyperhidrosis: it clearly reduces sweating in most patients. The effect varies from person to person and becomes clearer at follow-up.
No. It reduces sweating in the treated area, but the rest of the body keeps sweating to regulate temperature, which is normal and necessary.
Several months, often around six, varying with the person. When sweating returns, the session can be repeated.
It causes discomfort from the many micro-injections, moderate in the underarms and more sensitive in the hands and feet. An anaesthetic cream or skin cooling may be used depending on the area.
The effect appears within a few days and is complete around two weeks.
Yes, after discussion: the injection is more sensitive and a temporary drop in finger strength is possible in the hands. The dermatologist adapts the anaesthesia and technique.
The most common are pain at injection, small bruises and temporary tenderness. In the hands, temporary weakness of some muscles is possible. Risks are explained before the session.
This compensatory sweating is mainly described after certain surgical operations; it is rarely reported after Botox. If you are worried, it is discussed at the consultation.
As a precaution, it is avoided during pregnancy and breastfeeding. Other local solutions can be offered in the meantime.
Aluminium-salt antiperspirants, iontophoresis for hands and feet, certain oral medicines and, in rare cases, surgery. The choice depends on the area, intensity and your preferences.
The primary form is usually lasting: treatments control sweating, sometimes for many months, but must be renewed. A secondary form can improve by treating its cause.
The price is given by the clinic, as it depends on the areas treated. A detailed quote is given before any procedure; there is no single displayed price.
At the Skin & Aesthetic Clinic, in Guéliz, with Dr Sara Zahid, dermatologist, by appointment, in French, English or Arabic.
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