Concierge dermatology · UK
Iontophoresis + Botox - hyperhidrosis, treated properly.
Tap-water iontophoresis for palms and soles, botulinum toxin type A for armpits, face and scalp - planned together by a consultant dermatologist. No compensatory sweating, no surgery.
Why patients choose us
- 01
A consultant dermatologist, in clinic
A named dermatologist who treats hyperhidrosis every week - not a walk-in aesthetic room. The right diagnosis first, then the right combination.
- 02
Iontophoresis, Botox, or both - properly staged
Palms and soles love iontophoresis. Armpits love Botox. Some people need both. We plan the combination up front, not one at a time.
- 03
Independent, and free
We are paid by no clinic, so whether a home iontophoresis device, an in-clinic course or Botox is right for you is impartial and costs you nothing.
Indicative pricing
What private hyperhidrosis treatment costs in the UK.
Indicative ranges across our partner dermatology clinics. Send the details and we quote firm figures across two or three options, with cover checked.
In short
Axillary Botox in our network: £450–£850, effect lasts 4–7 months.
| Treatment | Indicative range | Typical duration | Turnaround |
|---|---|---|---|
| Dermatology consultation | £250–£450 | 30–45 min | Same visit |
| Tap-water iontophoresis course (6–10 sessions) | £300–£800 | 20–30 min per session | 3–5 weeks |
| Home iontophoresis device | £400–£700 | - | Delivered in 1 week |
| Botox for axillae (both sides) | £450–£850 | 20 min | Same visit |
| Botox for palms | £650–£1,200 | 30–40 min | Same visit |
| Botox for soles | £650–£1,200 | 30–40 min | Same visit |
| Combined iontophoresis + Botox package | £950–£1,800 | - | Staged over 4–6 weeks |
Prices vary by clinic, by the dermatologist, and by whether Botox is used for one site or several. A home iontophoresis device is a one-off cost that often works out cheapest over three years. We come back with a firm quote within one working day.
The problem
The right site, the right combination, and no compensatory sweating.
Hyperhidrosis is where general aesthetic clinics quietly under-deliver - armpits over-treated, palms under-treated, and sympathectomy pushed too soon. We fix all three before you start.
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Match the treatment to the site
Palms and soles do best with iontophoresis. Armpits, scalp and face do best with Botox. Getting this right doubles your success at half the cost.
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Combine, do not repeat
If you sweat everywhere, a single-modality plan fails. Iontophoresis for hands and feet plus Botox for armpits is the standard mixed package.
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Iontophoresis and Botox do not shift the sweating
Unlike sympathectomy surgery, neither treatment causes compensatory sweating elsewhere. That is the whole reason we favour them.
The journey
From enquiry to dry - what happens, in order.
One dermatologist from first message through iontophoresis course, Botox and home maintenance.
Phase 1 · Before treatment
Consult, severity score, topical trial
Phase 2 · Sessions
Iontophoresis and Botox
Phase 3 · After
Home device, top-ups
- 01
Before
You tell us what is going on
A short, confidential form. Which sites (hands, feet, armpits, face), how long, triggers, treatments already tried, and impact on work or social life.
- 02
Before
We come back with a recommendation
Within one working day: iontophoresis alone, Botox alone or both, and an indicative price. If a systemic cause needs excluding, we say so.
- 03
Before
Dermatology consultation
Face-to-face or video with a consultant dermatologist. Hyperhidrosis Disease Severity Scale scored, secondary causes excluded, and the right combination confirmed.
- 04
Before
Topical first-line where appropriate
Aluminium chloride or glycopyrronium wipes are trialled first where they suit - before iontophoresis or Botox commit you to a course.
- 05
On the day
Treatment session
Iontophoresis: 20–30 minute session, twice weekly for 6–10 sessions. Botox: 20 minutes for axillae, 40 minutes for palms or soles under topical or block anaesthesia.
- 06
On the day
Home device set up if chosen
For maintenance, a tap-water home device is supplied with a written protocol and one supervised setup call. Two sessions weekly at first, then maintenance.
- 07
After
Review, top-ups and long-term plan
Botox reviewed at 2 weeks and repeated at 4–7 months. Iontophoresis maintained at home. Annual dermatology review to keep the plan efficient.
Typical end-to-end: 3–5 weeks from enquiry to dry. Botox repeat every 4–7 months.
When it helps
When iontophoresis, Botox, or both are the right step.
The clinical pictures we see most, plus the one red flag that means medical review rather than another Botox appointment.
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Axillary hyperhidrosis
Sweat soaking through shirts within an hour, ruined fabrics, deodorant and antiperspirants no longer enough - the classic Botox territory.
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Palmar hyperhidrosis
Wet palms interfering with handshakes, typing, tools, sports and screens. Iontophoresis is usually first line; Botox is the alternative.
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Plantar hyperhidrosis
Damp feet, macerated skin, socks and shoes ruined, fungal infections. Iontophoresis and Botox both work - Botox to soles is the most uncomfortable.
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Craniofacial and scalp sweating
Forehead and scalp sweating driving embarrassment at work. Botox in small units is highly effective; iontophoresis is not suitable here.
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Failed antiperspirants
Prescription-strength aluminium chloride or glycopyrronium tried without success - the trigger to move on to iontophoresis or Botox.
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Compensatory sweating after ETS
Sweating that has shifted to the trunk or thighs after endoscopic thoracic sympathectomy - Botox is an option and iontophoresis rarely helps.
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Gustatory sweating (Frey syndrome)
Facial sweating triggered by food, usually after parotid surgery. Botox to the affected side is the treatment of choice.
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Red flag: new, generalised sweating
New-onset generalised sweating with weight loss, fevers or night sweats needs medical review - hyperthyroidism, infection or malignancy, not a Botox referral.
Treatment options
Modality and site both matter - here is the map.
What each option involves - tap-water iontophoresis, Botox by site, home devices and combined packages.
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Tap-water iontophoresis
Hands or feet placed in trays of tap water with a low direct current for 20–30 minutes. A course of 6–10 sessions dries the skin, then maintenance at home.
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Iontophoresis with glycopyrronium
The tap water is charged with a small dose of glycopyrronium - often more effective than water alone but requires prescription and monitoring.
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Home iontophoresis device
For long-term control. Bought outright and used twice weekly at first, then once a fortnight for maintenance. Best value if used properly.
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Botox for axillae
Around 100 units total across both underarms, injected in a grid pattern. Sweating reduced by 80–90 percent, effect lasts 4–7 months.
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Botox for palms
Around 100 units per palm under median and ulnar nerve block or topical anaesthesia. Excellent effect for 3–6 months. Transient weakness of fine hand grip possible.
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Botox for soles
Around 100 units per sole. Most uncomfortable of the sites - usually done under regional block or ice. Effect lasts 4–6 months.
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Botox for scalp and forehead
Micro-dose grid across the affected area. Very effective for craniofacial hyperhidrosis. Brow-drop is the main risk, so units are titrated carefully.
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Combined iontophoresis + Botox
A common package: iontophoresis for hands and feet, Botox for axillae. Covers most patients with generalised primary hyperhidrosis.
Our vetted UK network
A small panel of dermatologists, we picked them.
Consultant dermatologists with hyperhidrosis clinics across London and the major UK cities. Introductions are made privately, once we understand your case.
Selection criteria
How we choose every dermatologist in our network.
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Consultant dermatologists with a hyperhidrosis clinic, not general Botox providers
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Iontophoresis equipment on site and validated home device suppliers on the panel
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Regional anaesthesia available for palm and sole Botox where needed
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Long-term maintenance and repeat pathway agreed before the first session
Safety and recovery
What to expect afterwards - honestly.
Iontophoresis and Botox are both well-established. The things worth planning are the site, the repeat schedule, and the long-term cost.
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Botox is done in a clean clinic room, not a theatre
Botulinum toxin type A injections under topical or regional anaesthesia. Twenty minutes for axillae, longer for palms and soles. Straight back to work.
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Iontophoresis feels like pins and needles
Not painful but tingling - the current is gradually raised to a comfortable level. Metal jewellery removed and small cuts covered with petroleum jelly.
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Botox risks
Bruising, mild pain and temporary weakness of nearby muscles. Palm Botox can transiently weaken fine grip - reversible over 4–6 weeks. Never during pregnancy or breastfeeding.
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Iontophoresis risks and contraindications
Skin dryness and mild irritation are common. Not suitable in pregnancy, with cardiac pacemakers, metal implants at the treatment site, epilepsy or extensive open skin.
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Compensatory sweating does not happen
Unlike endoscopic thoracic sympathectomy (ETS), iontophoresis and Botox do not cause sweating to move somewhere else. This is the main reason we favour them over surgery.
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Botox is not permanent
Effect lasts 4–7 months for axillae, 3–6 months for palms and soles. Repeat sessions are needed to maintain the result - usually two to three times a year.
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Iontophoresis needs maintenance
After the initial 6–10 sessions, once a fortnight at home is usual. Stop maintenance and the sweating returns - but you can restart at any time.
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Costs add up over time
Botox is a repeat cost. A home iontophoresis device is a one-off. Over three years, home iontophoresis is often the cheapest option for palms and soles.
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Red flags after treatment
New generalised sweating with weight loss, fever or night sweats needs medical review, not another Botox appointment.
Reading your treatment note
Your treatment note in four parts. Read the last one first.
Whichever combination was used - iontophoresis, Botox or both - the note the dermatologist sends you keeps to the same shape.
A quiet reminder
Dermatology language is precise and can read coldly - we translate it for you.
If you would like us to talk you through the treatment note and the maintenance plan before your review, just ask.
- 01 Header
Diagnosis, sites and severity
Which sites are affected, how severe on the Hyperhidrosis Disease Severity Scale, and whether the cause is primary or secondary.
- 02 Technique
Treatment plan and units
Iontophoresis protocol, or Botox units per site and the grid used. Anaesthesia used and any topical adjuncts.
- 03 Findings
Response and side effects
How much reduction achieved, any bruising, weakness or skin irritation, and patient satisfaction score.
- 04 Impression
Maintenance and repeat plan
Read this first: when the next iontophoresis home session is due, when the next Botox is booked, and what red flags mean a same-week call.
Recognised by major UK insurers
Iontophoresis and axillary Botox for severe primary hyperhidrosis are often covered where topical treatment has failed. Palmar and plantar Botox are variably covered. We confirm cover before booking.
Frequently asked
Everything we get asked about hyperhidrosis treatment.
Quick answers on iontophoresis, Botox, sites, cost and long-term maintenance.
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Is hyperhidrosis Botox and iontophoresis on the NHS?
Yes but access is variable. Most NHS dermatology departments offer iontophoresis for palmar and plantar hyperhidrosis and Botox for severe primary axillary hyperhidrosis that has failed topical treatment. Waits can be long and courses limited - private care removes the wait and covers palms, soles and face which the NHS often does not.
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How does tap-water iontophoresis work?
Hands or feet are placed in shallow trays of tap water and a low direct current is passed through the water for 20–30 minutes. The current reduces sweat production for weeks. A course of 6–10 sessions over 3–5 weeks gets you dry; a home device maintains the result with a session every fortnight.
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How long does Botox for sweating last?
Around 4–7 months for the armpits, 3–6 months for palms and 4–6 months for soles. It is not permanent - you will need to repeat the treatment two or three times a year to maintain the effect. Many people find the difference to work and social life is worth it.
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Which sites suit iontophoresis and which suit Botox?
Iontophoresis is excellent for palms and soles and is the usual first line for those sites. Botox is excellent for armpits, scalp, forehead and face and is the usual first line for those. Palms and soles can be treated with Botox but the injections are uncomfortable and require regional anaesthesia.
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Does Botox for palms weaken the hand?
Fine grip can feel slightly weaker for 4–6 weeks - noticeable if you play a musical instrument or do precision work. It is reversible and usually mild. Coarse grip and general use are not affected. If fine grip matters to your job, we discuss the risk carefully before injecting.
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How much does treatment cost privately in the UK?
A dermatology consultation is £250–£450. A course of in-clinic iontophoresis is £300–£800. A home device is £400–£700 one-off. Botox for both armpits is £450–£850. Botox for palms or soles is £650–£1,200 per session. Combined packages start around £950. We confirm a firm figure within one working day.
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Are there long-term side effects?
No known long-term side effects for either treatment. Botox has been used at low dose for over 20 years for hyperhidrosis. Iontophoresis has been used for over 60 years. Neither causes compensatory sweating elsewhere, which is the main advantage over sympathectomy surgery.
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