Sweat patches on your shirt, damp handshakes, slippery phone screens? What hyperhidrosis (多汗症) is, how to tell it apart from normal sweating, and how hyperhidrosis treatment with sweat-blocking injections (止汗针) can help
Medically reviewed by Dr. Adriene Chee, Medical Director, Verve Clinic. Last updated: October 2026.
You choose dark shirts so the patches do not show. You wipe your palms before every handshake. Your paperwork smudges, your phone slips, and your shoes are damp by lunchtime. And it is not just the Malaysian heat: it happens in air-conditioned offices too.
If this sounds familiar, you may have hyperhidrosis, and you are far from alone. In this guide, Dr. Adriene Chee, a doctor with more than 10 years of experience, explains what hyperhidrosis is, how to tell it apart from normal sweating, and how sweat-blocking injections can give you months of relief.
What is hyperhidrosis (多汗症)?
In short: Hyperhidrosis (多汗症) is a common medical condition where you sweat far more than your body needs to cool down, usually from the underarms, palms or feet. It is treatable. Sweat-blocking injections (止汗针) halved sweating in 94% of patients in a major clinical trial, and results usually last 6 to 9 months.
Sweating is how your body cools down. In hyperhidrosis, the nerves that switch on the sweat glands are overactive, so they keep sending the signal even when you are cool and calm. In most people this is primary hyperhidrosis: it is not caused by another illness, often starts in childhood or the teenage years, and can run in families. In Malay, excessive sweating is often called peluh berlebihan.
It is more common than most people think. A 2016 survey of over 8,000 people in the United States found that about 4.8% have hyperhidrosis, roughly 1 in 20 people, yet only about half had ever spoken to a doctor about it.
Normal sweating or hyperhidrosis: how can you tell?
Everyone sweats in hot weather or during exercise. Hyperhidrosis is different because the sweating happens without a reason and gets in the way of daily life.
| Normal sweating | Hyperhidrosis | |
|---|---|---|
| When it happens | In heat, during exercise, or when stressed | Even when you are cool, calm and resting |
| How much | Stops when you cool down | Soaks clothes, drips from hands or feet |
| Where | All over the body | Usually underarms, palms, feet, sometimes face |
| Effect on daily life | Little | Affects clothing choices, work, social life and confidence |
Doctors usually diagnose primary hyperhidrosis when visible, excessive sweating in specific areas has lasted at least 6 months, together with at least two of these:
- it affects both sides of the body equally
- it happens at least once a week
- it interferes with your daily activities
- it started before the age of 25
- someone in your family has it
- it stops while you sleep
When to see a doctor sooner: if heavy sweating starts suddenly in adulthood, affects your whole body, happens mainly at night, or comes with weight loss or fever, see a doctor. These can be signs of another condition, such as a thyroid or hormonal problem, that needs checking first.
How does hyperhidrosis affect daily life?
Hyperhidrosis can affect work, relationships and confidence far more than most people realise. It is often dismissed as a minor nuisance, but people who live with it know otherwise. In the same 2016 survey:
- 85% said their sweating was embarrassing
- 71% said it caused them anxiety
- 35% said they had given up important things in their lives because of it
Many patients tell us they have changed jobs, avoided relationships or stopped raising their hand in class because of sweating. The good news is that effective treatment exists.
What are the options for hyperhidrosis treatment?
There are several options, from simple to surgical. Most people start with a stronger antiperspirant, and move on to sweat-blocking injections if that is not enough.
| Option | How it works | Good to know |
|---|---|---|
| Clinical-strength antiperspirant | Aluminium salts plug the sweat ducts | A sensible first step for mild cases; can irritate the skin |
| Tap-water iontophoresis | A mild electrical current through water reduces sweating | For palms and feet; needs regular, ongoing sessions |
| Oral medication | Prescription tablets that reduce sweating all over | Can cause dry mouth, dry eyes or blurred vision |
| Sweat-blocking injections (止汗针) | Botulinum toxin switches off the sweat signal in the treated area | Targeted, quick, little downtime; lasts 6 to 9 months |
| Microwave device | Heat destroys underarm sweat glands | For underarms only; swelling and tenderness for days |
| Surgery (sympathectomy) | Cuts the nerves that control sweating | Permanent, but compensatory sweating elsewhere is the most common and feared side effect |
Why we recommend injections: they treat exactly the area that bothers you, work within days, need no surgery or daily routine, and can be repeated safely. For many patients, they are the most practical way to take back control.
How do sweat-blocking injections (止汗针) work?
Sweat-blocking injections use botulinum toxin, the same type of treatment used for TrapTox and wrinkle relaxing, placed in tiny amounts just under the skin. It blocks the chemical signal between the nerve and the sweat gland.
Think of it as turning off a tap rather than removing the pipe: the sweat glands stay in place, but they stop receiving the message to produce sweat. As the effect gradually wears off over several months, the treatment can simply be repeated.
Do sweat-blocking injections really work?
Yes, and the evidence is strong. In a randomised, double-blind trial in the BMJ of 320 patients with underarm hyperhidrosis, 94% of those treated had their sweating at least halved after 4 weeks, compared with 36% on placebo. At 16 weeks, 82% were still responding. Treated patients also reported far higher satisfaction.
For sweaty palms, a 2014 study of 474 patients in the Journal of Drugs in Dermatology found that doctors rated improvement at 82% at 2 weeks and 83% at 1 month.
What happens during sweat-blocking injections?
Treatment takes about 20 to 45 minutes, depending on the areas. Your doctor confirms the area that sweats most, keeps you comfortable, then places tiny injections evenly across it.
- Consultation. Your doctor asks about your sweating, checks for any other cause, and confirms which areas to treat.
- Mapping the area. The sweating area is marked so every part is treated evenly.
- Comfort. For palms and feet, we apply numbing cream and use ice during treatment.
- Injections. Tiny amounts are placed just under the skin in a grid across the area.
- Review. We review you about 2 weeks after treatment to check the result.
| Underarms | Palms | Feet | |
|---|---|---|---|
| Comfort | Most patients find it very manageable | Numbing cream and ice | Numbing cream and ice |
| Treatment time | About 20 to 30 minutes | About 30 to 45 minutes | About 30 to 45 minutes |
| Results start | Within 7 days | Within 7 days | Within 7 days |
| Lasts | 6 to 9 months | 6 to 9 months | 6 to 9 months |
| Good to know | Usually no downtime | Grip may feel slightly weaker for a few weeks in some patients | Usually no downtime |
When will I see results, and how long do they last?
Most patients notice less sweating within 7 days, with the full effect at about 2 weeks. Results usually last 6 to 9 months, and many patients plan their next treatment before the hottest months or a big event.
| When | What you may notice |
|---|---|
| Straight after | Small bumps at the injection points that settle quickly |
| Day 7 | Sweating has reduced noticeably |
| About 2 weeks | Full effect; we review your result |
| 6 to 9 months | Sweating gradually returns; time to repeat |
Are sweat-blocking injections safe?
Yes. Botulinum toxin has been used to treat hyperhidrosis for more than 20 years. Side effects are usually mild and short-lived: small bumps or a small bruise at the injection points. After palm treatment, some patients notice their grip feels slightly weaker for a few weeks, which settles on its own.
Treatment is postponed during pregnancy and breastfeeding, and is not suitable for people with certain nerve or muscle conditions or an infection in the treatment area. Your doctor will check this at your consultation.
Who is a good candidate for sweat-blocking injections?
You may be a good candidate if you:
- sweat heavily from your underarms, palms or feet, even when you are cool and calm
- have tried strong antiperspirants without enough improvement
- plan your clothes, handshakes or activities around sweating
- want a quick treatment with little downtime and no surgery
- have an important event, interview or wedding coming up
A note from Dr. Adriene Chee: “Many patients apologise when they tell me about their sweating, as if it is their fault. It is not. Hyperhidrosis is a real medical condition, and it is very treatable. The most rewarding part is when patients come back for their review and tell me they wore a light-coloured shirt, or shook hands without thinking about it.”
Frequently asked questions
What is hyperhidrosis?
Hyperhidrosis (多汗症) is a medical condition where you sweat far more than your body needs to cool down. It most often affects the underarms, palms and feet, and it is common and treatable.
What causes hyperhidrosis?
In most people, the nerves that switch on the sweat glands are simply overactive. This is called primary hyperhidrosis. It often starts in childhood or the teenage years and can run in families. Less commonly, excessive sweating is caused by another medical condition or a medication.
Is excessive sweating normal in Malaysia’s hot weather?
Sweating more in hot, humid weather is normal. Hyperhidrosis is different: you sweat heavily even when you are cool, calm and resting, often enough to soak through clothes or drip from your hands.
What is 止汗针?
止汗针 means “sweat-stopping injection”. It refers to sweat-blocking injections of botulinum toxin, which switch off the signal to the sweat glands in the treated area.
How do sweat-blocking injections work?
They block the nerve signal that tells the sweat glands to produce sweat. The sweat glands stay in place, but they stay quiet in the treated area until the effect wears off.
How long do sweat-blocking injections last?
Results usually last 6 to 9 months, after which the treatment can be repeated.
When will I see results?
Most patients notice less sweating within 7 days, with the full effect at about 2 weeks.
Do sweat-blocking injections hurt?
Most patients find underarm treatment very manageable. For the palms and feet, which are more sensitive, we use numbing cream and ice to keep you comfortable.
Is there downtime?
Very little. You may see small bumps at the injection points for a short while and occasionally a small bruise. Most patients go straight back to their day.
Can you treat sweaty palms and feet?
Yes. We treat the underarms, palms and feet. Palms and feet are more sensitive, so we take extra steps to keep you comfortable.
Will my body sweat more elsewhere after injections?
Injections treat only the area that is injected, and most patients do not notice any change elsewhere. Your body can still cool itself normally through the rest of your skin.
Is it safe to stop sweating in my underarms?
Yes. The underarms make up a small part of your skin’s sweat glands, so blocking them does not stop your body from cooling itself.
Can I still use deodorant?
Yes, from the day after treatment. Many patients find they no longer need a strong antiperspirant.
Who should not have sweat-blocking injections?
They are postponed during pregnancy and breastfeeding, and are not suitable for people with certain nerve or muscle conditions, or an infection in the treatment area. Your doctor will check this at your consultation.
Can hyperhidrosis be cured?
Primary hyperhidrosis cannot usually be cured without surgery, but it can be controlled very well. Sweat-blocking injections keep sweating under control for 6 to 9 months at a time, and can be repeated whenever you need them.
Can men have sweat-blocking injections?
Yes. Underarm sweating that shows through work shirts is a common reason men seek treatment, and the treatment is the same for men and women.
Should I see a doctor if I suddenly start sweating a lot?
Yes. Sweating that starts suddenly in adulthood, affects your whole body, happens mainly at night, or comes with weight loss or fever should be checked by a doctor, as it can be a sign of another medical condition.
How much do sweat-blocking injections cost?
It depends on the areas treated, so we give a personalised quote after your assessment. WhatsApp us for a quote.
Ready to stop planning your day around sweat?
At Verve Clinic in Petaling Jaya, a doctor will assess your sweating, check for any other cause, and plan sweat-blocking injections for your underarms, palms or feet. WhatsApp us to arrange your assessment.
About the author
Dr. Adriene Chee is the Medical Director of Verve Clinic in Petaling Jaya. She has more than 10 years of experience. Her qualifications include an MD from the National University of Malaysia (UKM), a Postgraduate Diploma in Dermatology (Bangkok) and an LCP in Aesthetic Medicine. Meet our team.
This article is general information, not medical advice. Results vary from person to person. Please discuss the benefits and risks of any treatment with a qualified doctor.
