Hyperhidrosis — excessive sweating
Sweating you can’t control can be treated.
It is a medical condition, and a common one: some people simply sweat far more than their body needs to, whatever the weather, because the nerve signal to the sweat glands is overactive. It often runs in families. Because a few other conditions can cause sweating too, the first step is a doctor’s assessment to rule those out. Only then is the sweating itself treated, and every appointment, first to last, is with Dr Shah himself.
- Causes checked first
- Assessed, then treated
- Both underarms together
- No course to buy
Free consultation. If treatment is right for you, both underarms are treated at a second visit. The treatment is £445.
Online booking takes two minutes. The booking is a “Private medical consultation (S)”. Nothing in the invite or on your card statement names the condition.
02 — where most people start
Does this sound familiar?
Sweaty armpits rarely appear in a medical history. They show up in small decisions. The spare shirt in the bag. The dark colours. The arms kept down.
- Sweat marks within minutes of getting dressed, so you plan colours around it
- Antiperspirants have never quite done the job, or have stopped working
- It is worst in meetings, interviews or on dates, when you least want it
- It started in your teens or early twenties, and someone else in the family has it
- The skin under your arms gets sore, or smells despite washing
- You don’t wake up sweating; it is a daytime problem
If most of this is you, the pattern is the one most people with excessive sweating have, and it is the pattern a consultation is designed to confirm or rule out. That conversation is free.
03 — two kinds of sweating
Two kinds of sweating, and it matters which one you have
Most excessive sweating is primary focal hyperhidrosis: the nerves that switch on the sweat glands are overactive, so one or two areas sweat far more than they should. It usually starts in the teenage years, often runs in families, and is a fault in the nerve signal rather than a sign of illness. A minority of sweating is secondary, which means it is a symptom of something else. Telling the two apart is a doctor’s job, and it has to come before any treatment.
Signs that point to a cause worth finding
All over Over the whole body rather than one or two areas.
At night Waking with soaked sheets.
New in adult life Starting well into adulthood, with no family history.
One-sided One hand, one armpit, one side of the face.
With other symptoms Weight loss, fever, palpitations, tremor, swollen glands, feeling generally unwell.
After a new medicine Some antidepressants, strong painkillers, diabetes medicines and hormone treatments can cause sweating.
Most people have none of these. Where one is present, Dr Shah looks for the cause first, which may mean blood tests for the thyroid, blood sugar, blood count and inflammation, and sometimes hormone levels. They can be done here or through your own GP, and treatment waits until the answer is in.
What secondary sweating can point to
An overactive thyroid. Diabetes, or low blood sugar. The menopause. Infections, including ones that grumble on for weeks. Some medicines. Anxiety and panic disorder. Rarely, disorders of the blood or lymph glands. Most people who come with sweating have none of these. The ones who do need a different conversation, and the consultation is where that happens.
04 — how it is treated
Treatment is a ladder
You start on the lowest rung that is likely to work, and you step up only if it fails. That order is not caution for its own sake: skipping a rung is how people end up paying for treatment they never needed.
Aluminium chloride, around 20%. Ask a pharmacist for it; no prescription is needed. Apply it to completely dry skin at night and wash it off in the morning. Give it at least six weeks before judging it.1 Skin irritation is the usual reason it fails.
A weak electrical current passed through water, several times a week at first. Home devices are available. It works for palms and soles. It is awkward for underarms.
A prescription-only medicine injected into the skin of the underarm.4 It is for underarm sweating that has not responded to antiperspirant. Both underarms are treated at one visit. How it works is explained below.
Prescription tablets that damp down sweating across the whole body. Dry mouth, blurred vision and constipation limit who can take them. Sometimes useful when many areas are affected at once.
Cutting the nerve supply to the sweat glands. Kept for severe cases that have failed everything else. Heavy sweating elsewhere afterwards is common, and can be worse than the original problem.
So the pathway here is short. A free consultation, during which the underlying causes are checked and antiperspirant gets an honest look. Then, if underarm sweating is the problem and the lower rungs have failed, treatment in a single visit.
05 — how it works
Switching off the signal, not the gland
Sweat glands do nothing until a nerve tells them to, so the treatment works by interrupting that message where the nerve meets the gland. It acts where it is injected, and the glands themselves are unchanged; they simply stop receiving the instruction. The effect builds over about two weeks, then wears off over the following months as the nerve endings recover.
What happens on the day
Come with the underarm hair trimmed short, or shaved, two or three days before. No antiperspirant or deodorant that morning. The sweating area is mapped with a starch–iodine test. Sweating skin turns dark, which shows where treatment is needed. The pattern is photographed. Then a series of small, shallow injections is placed across the mapped area, roughly a fingertip apart. Most people describe pinpricks. A cold pack or numbing cream can be used. The visit is booked for an hour, though the injections themselves take around 20 minutes. You can go straight back to your day afterwards.
06 — who it helps
Who it helps
Most likely to help
Adults whose sweating is confined to the underarms. It began young, affects both sides, stops in sleep, and six weeks of aluminium chloride antiperspirant has not controlled it. That is the group the treatment is licensed for, and the group the clinical trials studied.5
Hands, feet and face
Sweating of the palms, soles or face is common too. Those areas are discussed at consultation rather than offered as a standard service here, and for hands and feet iontophoresis is often the first thing to try.
Things that need discussing first
Treatment is for adults only. Among the things that may rule it out, or need planning around, are pregnancy or breastfeeding, a neuromuscular condition, infection or broken skin in the area, a previous reaction to an injectable treatment, and some medicines, including blood thinners. This is not a complete list. The consultation is where suitability is actually decided.
07 — who treats you
Personally treated by Dr Gohar Shah
Every consultation and every treatment is carried out personally by Dr Gohar Shah. He is a GMC-registered doctor, a practising NHS GP, and holds a postgraduate diploma in dermatology. Hyperhidrosis is looked after by GPs and dermatologists. Here it is treated as a medical condition, in a consulting room, not as a cosmetic procedure.
GMC 6127983 — check the register
“Sweating is one of the few things people apologise for in a consulting room. My job is to take it seriously: find out whether anything is driving it, and if not, treat it properly.”
Private by design
Private room No waiting room. Appointments are spaced so that patients do not overlap.
Private booking Booked as a “Private medical consultation (S)”. The condition is never named in your booking, confirmation or calendar.
Private statement Your card statement shows only “VICTORIA PARK CLINIC”.
Private contact Every conversation, from enquiry to aftercare, is with Dr Shah directly.
08 — the first step
What it costs, and how to start
The decision today is a free consultation, not a treatment. It takes around 20 minutes, in person, and you leave with a clear next step: either a plan for the common kind, or tests to look for a cause, and in both cases an honest view of whether antiperspirant has had a fair trial. Treatment is never given on the same day. It is booked as a separate visit, so the decision is made in your own time rather than in the room.
£445
- Medical consultation and assessment, free
- Your sweating scored, mapped and photographed, so change can be measured
- Treatment of both underarms
- Written aftercare and direct contact with Dr Shah afterwards
- Check-in at two weeks, by message or in person, and a plan for when the effect wears off
Payment is taken on the day of treatment. Nothing is paid at the consultation. Nothing is owed if treatment is not recommended, or you decide against it.
If it does not work
Some people respond patchily, or not at all. Patches missed at the first visit are dealt with at the two-week review, but if there is no meaningful change the next step is discussed openly: a different rung of the ladder, or a referral. A second treatment is not recommended simply because the first did not work.
The NHS route
This treatment is sometimes available on the NHS through a GP referral to dermatology, though whether it is funded, and how long the wait is, depends on where you live. If that is the better route for you, Dr Shah will say so rather than treat you privately.
Pricing terms
Before you decide
It is a prescription medicine. Not everyone is suitable, and it has side effects.
Results vary. Some people get little benefit.
The side effects seen most often are soreness and small bruises at the injection sites, and some people notice sweating elsewhere for a while. The full list is in the medicine’s own leaflet, which is gone through with you at consultation.
The effect wears off. Repeating it is a choice each time.
If an underlying cause is suspected, that is investigated first. This is why the consultation comes before anything else.
09 — questions
Frequently asked
How much does it cost?
The consultation is free. Treatment of both underarms is £445, paid on the day of treatment. There is no course to buy and nothing to pay if treatment is not recommended.
What is actually injected?
A prescription-only medicine. It is licensed in the UK for severe underarm sweating that has not responded to antiperspirants. By law, prescription-only medicines cannot be advertised to the public, so it is not named here. It is explained fully at your consultation, with the manufacturer’s own patient leaflet, before you decide anything.
Does it hurt?
Most people describe a series of pinpricks over a few minutes on each side. A cold pack or numbing cream can be used, and the needle is very fine. If needles worry you, say so when you book. The appointment is paced for it.
How soon does it work, and how long does it last?
Sweating usually starts to reduce within a few days, and the full effect arrives at about two weeks. From there it typically lasts four to seven months, sometimes longer, before wearing off gradually. Treatment can be repeated when it does, but not sooner than about four months.
Will I sweat more somewhere else instead?
Some people do notice more sweating elsewhere, on the trunk or back for example, for a while after treatment. It is usually mild and settles, but it is a recognised effect and it is discussed before you decide. Heavy sweating elsewhere, to make up for the treated area, is a problem of surgery rather than of injections.
Do I have to try antiperspirant first?
Yes, and properly. Aluminium chloride around 20%, on completely dry skin at bedtime, washed off in the morning, for at least six weeks. Many people were never told how to use it and give up early. If it works, you have solved the problem for a few pounds. If it does not, or your skin will not tolerate it, treatment is the next rung.
Can I have my hands, feet or face treated?
Those areas are discussed at consultation, but they are not a standard service here. For hands and feet, iontophoresis is often the first thing to try.
I have a wedding, interview or holiday coming up. How far ahead should I book?
Allow four weeks if you can. The consultation comes first. Treatment is a separate visit, and the full effect takes about two weeks to arrive. Three weeks is workable. Less than two is cutting it fine, and Dr Shah will say so rather than treat you too close to the day.
Can I get this on the NHS?
Sometimes. Your own GP can refer you to a dermatology clinic, and some NHS areas fund treatment where antiperspirant has failed. Availability and waiting times vary a great deal. If the NHS route looks right for you, Dr Shah will tell you at the consultation.
What should I bring to the consultation?
The antiperspirant you have been using, and a list of your medicines, including anything bought over the counter or online. If you have had blood tests in the last year, bring the results or say where they were done. Nothing else is needed.
What should I do before and after?
Before: shave two or three days ahead. Use no antiperspirant or deodorant on the day. After: avoid heavy exercise, saunas and hot baths for the rest of the day, and leave the area alone. You can use antiperspirant again from the next day. A review is arranged at two weeks.
Is my privacy protected — what shows on my statement?
Your card statement shows “VICTORIA PARK CLINIC”, the same as for any other service. The booking is a “Private medical consultation (S)”. It asks only for your name, email and phone number. A short letter is available for your own GP, so they have the record. It is not sent unless you ask.
Is there parking?
Yes. Victoria Park Square has free on-street parking all day at weekends and after 5.30pm on weekdays, and the clinic has two driveway spaces you are welcome to use, subject to availability on the day. At other times, apps such as JustPark list nearby spaces. If you cycle, there are bike stands in the front courtyard, and if you prefer the Tube, the clinic is a two-minute walk from Bethnal Green station.
Ready when you are
Book a consultation
A one-to-one consultation with Dr Shah, so you explain the problem once and the same doctor sees you throughout. It is free, and it commits you to nothing.
Booking takes two minutes.
Prefer to call? 07345 008 695
Not ready to book? Send a confidential enquiry below and Dr Shah will reply personally.
Your consultation and treatment are provided personally by Dr Gohar Shah (GMC 6127983), at a private consulting room in Bethnal Green.
Notes
- Sold without prescription. Irritation can often be managed by using it on alternate nights, and by making sure the skin is bone-dry before applying. ↩
- Your medical care is provided by Dr Gohar Shah as an independent practitioner. Payment is collected by GS Medical Services Ltd, trading as Victoria Park Clinic, which issues invoices and handles refunds; it appears as “VICTORIA PARK CLINIC” on your statement. The consultation is free of charge, and there is nothing to pay if treatment is not recommended or you decide not to proceed. ↩
- Treatment is for adults aged 18 and over. ↩
- By law, prescription-only medicines may not be advertised to the public in the UK. This page describes the assessment and the treatment pathway. The medicine itself, its licence and its patient information leaflet are discussed with you at consultation. ↩
- The main randomised, placebo-controlled trials in underarm hyperhidrosis: Naumann & Lowe, BMJ 2001, and Lowe et al, J Am Acad Dermatol 2007. No success figures are quoted on this page, by design. They are discussed at consultation, in the context of your own case. ↩