Hyperhidrosis Treatment in Puebla

What is hyperhidrosis?

Hyperhidrosis is excessive sweating beyond what the body needs to regulate its temperature. It is not about hygiene or nerves: it is a common, treatable medical condition that mainly affects the underarms, the palms of the hands, the soles of the feet, and the face or scalp.

Two forms are distinguished, and telling them apart is the first step. Primary or focal hyperhidrosis is the most common: it appears symmetrically in specific areas, usually begins in adolescence or youth, worsens with heat and stress, and answers to no underlying disease. Secondary hyperhidrosis is the consequence of another cause —a thyroid or hormonal problem, menopause, certain medications, an infection— which is why the assessment always begins by ruling it out, because in that case what must be treated is the cause.

Sweating is normal and necessary; the problem is the excess and the timing. Someone living with hyperhidrosis changes their shirt by mid-morning, avoids shaking hands, ruins documents, keyboards or the steering wheel, and chooses clothing for how well it hides sweat rather than for how they like it. The good news is that a ladder of treatments —from a prescription cream to botulinum toxin injection— controls the problem in the great majority of cases, with no need for surgery.

Techniques used by Dr. Arístides Arellano

There is no single treatment for excessive sweating: there is a ladder that runs from the simplest to the most specific. Dr. Arístides Arellano starts with the least invasive method that solves your case and moves up only if needed. The option is defined at the consultation, according to the affected area, the intensity, and whether you have already tried other treatments:

• Prescription antiperspirants (aluminium salts): the first rung for mild-to-moderate hyperhidrosis, especially of the underarms. These are more concentrated formulas than an over-the-counter deodorant; applied at night on dry skin, they temporarily plug the gland duct. Simple and low-cost, but they can irritate and are not enough in intense cases.
• Botulinum toxin (injection): the reference treatment for underarm sweating and also useful in the palms. It is injected into the dermis through multiple micro-punctures spread across a grid; the toxin blocks the nerve signal that tells the gland to sweat, without damaging it. The effect begins within a few days, is temporary and reversible —it lasts several months— and is repeated when sweating returns.
• Topical or oral anticholinergics: medications that reduce sweating more generally. They are reserved for selected cases and by prescription, because they can cause dry mouth, blurred vision or other effects; their indication is assessed individually.
• Iontophoresis: particularly indicated for the palms and soles. The area is immersed in water through which a mild electric current passes, reducing sweat production over repeated sessions; it can be continued at home with suitable equipment.
• Study of the cause and referral when appropriate: if the sweating is secondary, the right thing is to treat the underlying disease, not the symptom. And in the severe cases resistant to everything above where surgery (sympathectomy) is raised, it is a last-resort decision, with a risk of compensatory sweating elsewhere, discussed frankly and referred to the appropriate specialist.

How is it performed?

The most representative in-office treatment, botulinum toxin, is done on an outpatient basis and without an operating room: the session lasts 15 to 30 minutes and you walk out the same day, with no dressings and no rest. It never requires general anaesthesia.

First the over-sweating area is identified. The Minor (starch-iodine) test may be used for this: it stains the skin dark where sweat is present and precisely maps the zone to treat. A grid is then marked and the toxin is injected into the superficial layer of the skin with a very fine needle, at multiple shallow points. In the underarms the discomfort is mild; in the palms, which are more sensitive, cold, topical anaesthetic or a local block can be used to keep it comfortable.

The effect is not immediate: sweating begins to decrease between the second and seventh day, and the full result is seen at about two weeks. From then on the area stays dry for several months; when the sweat returns, the session is repeated. The topical options —prescription antiperspirants— and iontophoresis follow a different rhythm, of repeated and sustained application over time, and are frequently combined with the toxin for the areas that bother most.

Every medical treatment —botulinum toxin injections and prescription topicals included— carries risk and requires a prior medical assessment to rule out an underlying cause. The toxin's effect is temporary and reversible, and not everyone responds the same way: results may vary according to each patient, the cause of their sweating and their individual response to treatment.

Who is a good candidate?

A good candidate has excessive, localised and persistent sweating that affects daily life, in good general health and with realistic expectations that this is a renewable control and not a definitive cure. The consultation confirms it is primary hyperhidrosis and rules out a secondary cause:

• Underarm sweating that soaks clothing, forces a change of shirt during the day, or rules out certain garments and colours.
• Damp or slippery hands that make shaking hands, writing, using tools or a phone difficult, and that affect social or professional life.
• Soles of the feet that are constantly damp, or sweating of the face and scalp that drips with heat or stress.
• Patients who already tried over-the-counter deodorants without result and are looking for a stepped medical solution.
• It is not the best option, or it requires prior study, for someone with recent-onset generalised sweating, night sweats or accompanying symptoms that suggest an underlying cause; in those cases the first step is to study the origin, not to inject.

Recommended post-treatment care

Sweating treatment has practically no downtime: after a toxin injection you are advised to avoid intense heat, vigorous exercise and the sauna, not to rub the area during the first 24 hours, and not to apply antiperspirant that day. Dr. Arístides gives care instructions according to the treated area and schedules a review at about two weeks to assess the effect. See the full guide: Post-surgical recovery and care.

Before and after

Most patients want to see before-and-after photographs before deciding. Out of respect for each person’s privacy, Dr. Arístides Arellano shows real cases —always with documented consent— during your in-person consultation, where you can review results from patients with a starting point similar to yours. Results may vary from patient to patient.

Approximate price

The cost of hyperhidrosis treatment depends on the indicated technique, on the area and its extent —one underarm is not the same as both palms— and, in the case of botulinum toxin, on the amount of product each area requires, so it is set at your consultation with a written quote before starting. Approximate price — the definitive cost is set at your private consultation with Dr. Arístides Arellano. See the price list.

About Dr. Arístides Arellano

Dr. Arístides Arellano is a plastic surgeon holding a specialty licence: he practises under a Mexican medical licence (D.G.P. 1125959) and a specialty licence in Plastic & Reconstructive Surgery (0002008), both issued by the Directorate General of Professions (DGP), which reissued his certificate of professional standing in 2025. His career began before Mexico’s present-day specialty-board system existed: he belongs to the founding generation of plastic surgery in Puebla, the second generation of a surgical tradition started in 1971 by Dr. Francisco Arellano Ocampo. Trust is verified, not promised: both licences are public and anyone can look them up in the DGP’s National Registry of Professionals.

Related patient guide

Before deciding who should treat you, it is worth getting informed: How to choose a plastic surgeon in Puebla — part of the series of informational guides reviewed by Dr. Arístides Arellano.

Trust is verified, not promised. All 210 scanned documents —degree, licences, diplomas, publications and certificates, from 1977 to 2025— are open in Dr. Arístides Arellano’s credential archive, alongside an explanation of the difference between a specialty licence and a board certification.

What to expect · from treatment to result

• The same dayThe toxin session lasts 15 to 30 minutes and you walk out, with no dressings and no rest. Intense heat, vigorous exercise and rubbing the area are avoided for 24 hours.
• Days 2–7Sweating begins to decrease progressively as the toxin takes effect.
• Around 2 weeksThe full result is seen: the treated area stays dry. This is the moment for the review, to check whether any point needs a touch-up.
• The following monthsThe effect lasts several months. In the underarms it usually lasts longer than in the palms, though it varies from person to person.
• When sweat returnsThe session is repeated to maintain control. Topical treatments and iontophoresis, by contrast, are applied in a sustained way over time.

Frequently asked questions

Every figure published on this site is approximate and is not a quote. Any procedure or treatment first requires a private assessment consultation with Dr. Arístides Arellano —$800 MXN, charged separately— and it is at that consultation that the definitive cost of your case is determined.

Educational content; it does not replace a medical consultation. Results may vary from person to person.