Hyperhidrosis is a medical condition rather than a cosmetic complaint, and people who have it generally know the difference. It means changing shirts at lunch, choosing clothing by how well it hides, planning around handshakes, and finding that clinical strength antiperspirants stopped working years ago. It is also more common than most people who have it realise, and it is treatable.
SweatZap™ was developed by Sam Assassa, MD, who founded Beverly Hills Aesthetics in 1995 and is board certified in Internal Medicine. He trained and practiced in internal medicine before moving into aesthetics.
Primary Versus Secondary Hyperhidrosis
This distinction comes first, because one of these needs a medical workup rather than a cosmetic treatment.
Primary focal hyperhidrosis is the common form. It affects specific areas, usually the underarms, palms, soles, or face, it is generally symmetrical, it typically begins in adolescence or early adulthood, it frequently runs in families, and it stops during sleep. There is no underlying disease. The nerves signalling the sweat glands are simply overactive.
Secondary hyperhidrosis is different. It is sweating caused by something else, and the signs that point to it are worth knowing: sweating that is generalised rather than confined to specific areas, sweating that began suddenly in adulthood rather than gradually in youth, sweating that occurs during sleep, or sweating accompanied by other changes such as weight loss, fever, or fatigue.
Thyroid conditions, blood sugar problems, certain medications, infection, and hormonal changes can all cause it. Where the pattern suggests secondary hyperhidrosis, identifying the cause comes before treating the appearance, and Dr. Assassa’s background in internal medicine informs that assessment.
Where It Occurs
The underarms are the most common site and the most straightforwardly treated. Palms and soles are common and more difficult, since the skin there is thicker and treatment is more uncomfortable. Facial and scalp sweating is less common and affects people disproportionately, since it cannot be concealed.
Why Antiperspirants Stop Working
Antiperspirants work by temporarily plugging the sweat duct at the surface. They are genuinely effective for ordinary perspiration and they are working against a much larger volume in hyperhidrosis.
Clinical strength formulations help some patients and irritate others, and many people cycle through several before concluding nothing works. That is a reasonable conclusion. Surface treatment is not addressing the signal driving the gland.
How Excessive Sweating Is Treated
Two approaches, and they work differently.
Botox® injections interrupt the nerve signal telling the sweat glands to produce. Treatment of severe primary underarm hyperhidrosis is an FDA approved indication, which is unusual among aesthetic treatments and worth knowing. Treatment of the palms, soles, face, and scalp is off label. Results are repeated periodically.
SweatZap™ takes a different approach, targeting the sweat glands themselves through a small incision under local anesthesia in a single session rather than interrupting the signal to them.
Which suits you depends on the area affected, how severe it is, and whether you would rather repeat a short treatment periodically or have one longer procedure.
Have Your Sweating Assessed in Beverly Hills
Dr. Assassa will establish whether your pattern fits primary hyperhidrosis or suggests an underlying cause worth investigating first, then discuss which treatment fits the area affected. Request a consultation or schedule your appointment online.