Hyperhidrosis (Excessive Sweating) Treatment
Sweating through a shirt in an air conditioned office, avoiding handshakes, or planning outfits around underarm marks are common experiences for people with hyperhidrosis. The condition is medical, not a hygiene problem, and it can affect work, relationships, and confidence far more than most people realize. Patients from Beverly Hills, Santa Monica, West Hollywood, and across Los Angeles come to Parsa M.D. for an evaluation that confirms the type of sweating and a treatment plan that can bring it under control.
Excessive sweating is usually a harmless overactivity of the sweat glands, but it can also be the first sign of a thyroid, hormonal, or medication issue, so the evaluation starts with the whole patient. Dr. Kami Parsa completed an internal medicine internship at UCLA before his ophthalmology residency and his fellowship in oculoplastic and reconstructive surgery, and he holds hospital affiliations with Cedars-Sinai Medical Center and Los Angeles General Medical Center. As founder and program director of Core Aesthetics, he also trains other physicians in advanced aesthetic and oculoplastic techniques, including precise injection work.
“Patients with hyperhidrosis have usually tried every antiperspirant on the shelf before they come in, and many have been told it is just nerves. It is a real condition with real treatments, and the first step is making sure nothing else is driving it.” — Dr. Kami Parsa
What Is Hyperhidrosis?
Hyperhidrosis is sweating beyond what the body needs to stay cool. It falls into two broad types, and telling them apart shapes the entire plan:
- Primary focal hyperhidrosis: The most common type, affecting specific areas such as the underarms, palms, soles, face, or scalp on both sides of the body. It usually begins in childhood or the teen years, often runs in families, and does not occur during sleep.
- Secondary hyperhidrosis: Sweating caused by something else, such as an overactive thyroid, low blood sugar, menopause, infection, certain medications, or less commonly other medical conditions. It is often more widespread and can occur at night.
Primary hyperhidrosis comes from overactive signals from the nerves that stimulate sweat glands rather than from the glands themselves. Heat, exercise, and stress can trigger episodes, but people with the condition sweat heavily even without them.
How Hyperhidrosis Is Evaluated
The consultation reviews where you sweat, when it started, whether it happens during sleep, family history, and your medications and overall health. Dr. Parsa or a licensed member of his clinical team may assess how much sweating occurs and how it affects daily life. If the pattern suggests secondary hyperhidrosis, such as new sweating in adulthood, sweating all over, night sweats, fever, or unexplained weight loss, you will be referred to your physician for testing before cosmetic treatment. Team members are described on our Our Providers page.
Hyperhidrosis Treatment Options in Beverly Hills
Treatment usually moves from the simplest option to more involved ones:
- Prescription strength antiperspirants: Aluminum chloride products and prescription topical medications are often the first step for underarm sweating.
- BOTOX® injections for the underarms: BOTOX® is FDA-approved for severe underarm sweating in adults when topical treatments have not worked. Small injections block the nerve signal that activates the sweat glands, and results typically last several months.
- Other areas: Neurotoxin use on the palms, soles, face, or scalp is off-label. Palm treatment can cause temporary hand weakness, and forehead treatment can affect brow position, so these areas need careful planning.
- Other treatments: Iontophoresis for the hands and feet, device treatments for the underarms, oral medications, and surgery are additional options that may be discussed or referred when injections are not the right fit.
Results from BOTOX® usually begin within a few days and reach their full effect in about two weeks. Treatment is repeated when sweating returns, and many patients schedule injections before the warmer months.
Risks and When to Seek Care
Injection site discomfort, mild bruising, and temporary swelling are common. Some patients notice more sweating in other areas after underarm treatment. All neurotoxins carry an FDA boxed warning about the rare spread of effect beyond the injection site. Seek emergency care if you develop difficulty swallowing, speaking, or breathing, or new generalized weakness, after treatment. See a physician promptly for night sweats, fever, or unexplained weight loss, since these are not typical of primary hyperhidrosis.
Why Choose Dr. Parsa for Hyperhidrosis Treatment
- Neurotoxin Experience Rooted in Ophthalmology: Botulinum toxin was first developed as a medical treatment for eye muscle conditions, and his ophthalmology training at USC’s Doheny Eye Institute grounds his use of it.
- Advanced Training: Fellowship training at the Bascom Palmer Eye Institute built his skill in precise, small volume injections around delicate structures.
- Teaching Role: He is an Adjunct Clinical Professor at the Keck School of Medicine of USC.
- More Than 20 Years of Experience: Two decades of clinical practice inform careful dosing and realistic expectations.
- Discreet Setting: Treatment takes place in a private Beverly Hills office with a team used to caring for patients who value privacy.
Schedule a Hyperhidrosis Consultation in Beverly Hills
Your visit takes place at our office at 465 N Roxbury Dr, Suite 1011, in Beverly Hills. Dr. Parsa and his team will confirm the type of sweating you have and walk you through the options that fit. Contact our office to request an appointment.
Medically reviewed by Kambiz K. Parsa, M.D. on
