Hyperhidrosis is excessive, hard-to-control sweating from eccrine sweat glands. It may be limited to areas such as the underarms, palms, soles or face, or it may affect the whole body. At Silk Clinical in Christchurch, assessment comes first. A consultation is how we review your history and discuss which options, if any, are suitable.
When sweating may be excessive
DermNet New Zealand describes sweating as more than ordinary if it soaks or stains clothing, or if it gets in the way of work or daily tasks.
Primary hyperhidrosis typically starts in childhood or adolescence, may run in families, tends to affect both sides of the body (often the underarms, palms or soles), and usually eases at night and stops during sleep.
Secondary hyperhidrosis is less common. It is more likely to be one-sided, uneven or whole-body, can occur at night, and may be linked to endocrine or neurological conditions or to medicines. The International Hyperhidrosis Society and DermNet agree on the same warning signs: see a GP first if sweating is one-sided, started later in adult life, occurs at night, affects the whole body, or began after a new medicine. Silk Clinical does not investigate secondary causes beyond taking a history.
This page is for adults with long-standing sweating in both underarms that interferes with daily life, after ordinary antiperspirant use. It is not a path for untreated secondary causes, or for buying a medicine without assessment.
One published review of primary hyperhidrosis describes criteria as six months of visible, focal, excessive sweating plus at least four of: palms, soles, underarms or face; both sides; disruption of daily activities; at least weekly episodes; onset before 25; family history; and no night sweating. That is one formulation, not a single official test.
What an assessment covers
Hyperhidrosis is usually diagnosed clinically. A consultation covers the sites involved, how long it has been present, family history, triggers, medicines, and the effect on daily life.
You may be asked to rate how much sweating interferes with daily activities: never noticeable; tolerable but sometimes interfering; barely tolerable and frequently interfering; or intolerable and always interfering. That four-point scale is a severity tool used in secondary care. Those questions help the conversation. They are not a diagnosis from this page.
The precise site of localised sweating can be mapped in clinic with an iodine-starch test. If secondary generalised hyperhidrosis is suspected, DermNet advises screening that includes, as a minimum, blood sugar or glycosylated haemoglobin and thyroid function. Silk does not run those laboratory tests and does not replace your GP. The American Academy of Dermatology makes the same point a different way: there is no single best treatment, and a plan is built around the individual.
What can be discussed publicly
Aluminium-salt antiperspirants are a usual first step. Clothing choices and avoiding known triggers can also help. A GP may discuss iontophoresis or oral medicines where those are appropriate.
A clinic consultation can discuss whether an injectable option is suitable for primary underarm sweating. The New Zealand Society of Cosmetic Medicine treats hyperhidrosis as an approved medical use that may be advertised, while unapproved sites must not be. Product, dose and cost are confirmed only after assessment. This page does not name a prescription medicine or list a price.
This page does not promise dryness in every case, a set length of effect, or that any option is free of side effects. The Therapeutic and Health Advertising Code does not permit those claims, and they would not be true. Individual results vary.
Risks and alternatives
Strong antiperspirants can irritate the skin. Other options a GP or specialist may discuss include iontophoresis, oral anticholinergic medicines, surgical removal of axillary sweat glands, and endoscopic thoracic sympathectomy, which DermNet notes is reserved for severe cases because of compensatory sweating and other surgical risks. Those surgical pathways are referrals, not procedures Silk Clinical provides.
If an injectable option is considered, possible side effects are explained in consultation. They are not absent, and results vary from person to person.
Book a consultation
Consultations are with Shontelle Prasad, Registered Nurse (Nursing Council of New Zealand 301636), working with a collaborating prescriber. A group doctorate in research methods and complexity is not a medical or nutrition qualification and has no role in this pathway or in prescribing.
A visit includes history, assessment and a written quote. You are not obliged to go ahead with treatment on the day.
Book a consultation online, call 03 365 5774, or come to 66 Victoria Street, Christchurch.
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