Hyperhidrosis and excessive sweating in Metro Vancouver

Hyperhidrosis is sweating that goes beyond what the body needs to cool itself, usually at specific sites such as the underarms, palms, soles or face. The common form, primary focal hyperhidrosis, has no underlying disease behind it, tends to start in childhood or adolescence, affects both sides of the body evenly, and eases during sleep. A less common form, secondary hyperhidrosis, is caused by another medical condition or a medication and can be generalised, one-sided or worse at night. It affects an estimated 1 to 3 percent of people and is treatable.

Yes, they reduce it substantially. A series of tiny injections into the underarm skin interrupts the nerve signal that switches on the sweat glands, so the area produces much less sweat. In the pivotal randomised trial of 320 patients, 94 percent of treated patients achieved at least a 50 percent reduction in sweat at 4 weeks, against 36 percent on placebo. This is a Health Canada approved use in adults for the underarms. It reduces sweating rather than removing every drop, and the effect is temporary and repeatable.

For the underarms, the effect lasts about 4 to 6 months for most people, and sometimes longer, before it is repeated. A 52 week randomised study confirmed that the benefit is sustained when treatment is repeated. Sweating returns gradually as the nerve endings recover, which is the signal to book the next treatment. Duration varies from person to person, and your physician will tell you what to expect for you.

The cost depends on the treatment and the dose your plan needs, so it is quoted for you after the physician assesses you. Neuromodulator injections for sweating are commonly priced by the amount of product used, and the physician explains the dose and the price in person. Your consultation is complimentary. These are private esthetic services and are not covered by MSP.

Yes. Excessive sweating is a recognised medical condition with a clear treatment ladder, from clinical strength antiperspirants, up to injections and energy devices, and in severe cases surgery handled elsewhere. For underarm sweating, neuromodulator injections are the best evidenced option and a Health Canada approved use in adults. The right step depends on the site, the severity and what you have already tried, which is what the consultation works out.

It can, but the evidence and the approach differ from the underarms. The underarm is the on-label, best evidenced site for neuromodulator injections. Treating the palms, soles and face with the same injections is practised and can help, but it is an off-label use, it tends to be more uncomfortable, and the effect can be shorter, so the physician explains the trade-offs and the options honestly. Iontophoresis, a treatment that sits in medical care, is often used for sweaty hands and feet.

The injections use botulinum toxin type A to switch off the nerve signal to the sweat glands, and they are the better evidenced option, approved in adults for the underarms and studied in randomised trials. Sylfirm X is a radiofrequency microneedling device that heats the sweat glands and is a newer, secondary option for people who would rather not repeat injections. A 2024 randomised trial that compared the two found the injections clearly more effective at 6 months, 75 percent treatment success against 30 percent, and there is no published trial of this specific device for sweating. The physician talks the injections through first for underarm sweating.

The underarm injections use very fine needles, usually after ice or a numbing cream, and most people feel brief stings with no real downtime, at most a little redness or pinpoint bruising. Radiofrequency microneedling is done after a numbing cream and feels like pressure and heat, with redness for a few hours up to a day. You can return to normal activity the same day with either. We explain the sensation and recovery for your specific plan before you book.

It can, which is why the pattern matters. Primary focal sweating, the common form, is not dangerous, only troublesome. Sweating that is generalised across the body, happens mainly during sleep as night sweats, comes on suddenly, is one-sided, or starts later in adult life can point to an underlying condition or a medication effect, and that belongs with your family doctor first. Seek medical care promptly for heavy sweating with dizziness, chest pain, or a cold, racing pulse. BioPlus assesses for these features and routes you to medical care when they are present.

Yes. Neither treatment targets pigment, so neither carries the pigmentation risk that pigment-seeking lasers can carry in deeper skin. Neuromodulator injections have no pigment target and showed comparable results in people with skin of colour in a phase 3 analysis. Radiofrequency microneedling delivers energy through fine needles rather than through absorbed light, so it also works across tones, with standard technique care. BioPlus has treated skin across every tone since 1996.