Virtual consultation
Which treatment step are you at?
This tool walks you through the same treatment algorithm used in clinic for underarm (axillary) and hand (palmar) hyperhidrosis — from prescription antiperspirants to Botox, miraDry, and ETS surgery. Answer a few questions to see which step likely applies to you. It is for information only — not a diagnosis or a treatment decision.
Frequently asked questions
What is the treatment pathway for hyperhidrosis?
Most clinics follow a step-up approach: prescription-strength antiperspirants first, then Botox injections if those aren’t enough, then a permanent option — miraDry for underarms or ETS surgery for hands and underarms — for sweating that doesn’t respond to earlier steps.
Do I have to try Botox before ETS surgery?
Generally yes. ETS is reserved for palmar or axillary hyperhidrosis that hasn’t responded to topical treatment and Botox, since it’s the most invasive step in the pathway. For how Dr. Irshad performs it and why, read his take on ETS surgery.
Is this virtual consultation a real medical assessment?
No. It’s an educational tool that mirrors the clinic’s treatment algorithm, for information only. An actual assessment and treatment decision happens at a formal consultation, which requires a physician referral.
Does this tool apply to all types of sweating?
It covers primary focal hyperhidrosis of the hands and underarms. If your sweating is whole-body, occurs at night, or started recently, the tool will flag that you should see your family doctor first rather than follow this pathway.
Medically reviewed by Dr. Kashif Irshad, MD, MSc, FRCSC · Last updated August 2026
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