Markham, Ontario · Physician-performed

Hyperhidrosis Treatment in Markham

Reduce excessive underarm, hand, or foot sweating with quick, effective neuromodulator treatments that temporarily block overactive sweat glands. Treatment is minimally invasive, requires no downtime, and provides months of relief while improving comfort and confidence.

Price

from $400

Appointment

30 minutes

Performed by

Dr. Mazzuca, MD

Location

Markham, ON

Book a Consultation   Book Excessive Sweating directly

Quick answer

Hyperhidrosis treatment in Markham at Dr. Monique Mazzuca Aesthetics is from $400, performed personally by a licensed physician (MD, CCFP) at 200 Cachet Woods Court, Suite 309, in a 30-minute appointment. Small amounts of a neuromodulator are injected into the skin of the underarms, palms or soles to temporarily switch off the signal that drives overactive sweat glands. Most patients notice less sweating within a few days, see the full effect by about two weeks, and get several months of relief, often around six months for the underarms. There is no downtime. New patients start with a $50 consultation.

What hyperhidrosis is

Hyperhidrosis is sweating well beyond what the body needs to stay cool. It is a recognised medical condition, not a hygiene problem, and it is common: many people live with it for years before they learn it can be treated. Typical signs are sweat that soaks through shirts within minutes, palms that drip onto paper or keyboards, shoes that are damp by midday, and sweating that happens in a cool room while sitting still.

There are two main types. Primary (focal) hyperhidrosis usually starts in childhood or the teenage years, affects specific areas such as the underarms, palms, soles or face on both sides, often runs in families, and typically stops during sleep. Secondary hyperhidrosis is caused by something else, such as a medication, an overactive thyroid, diabetes, menopause, an infection or, rarely, a more serious illness. It is more likely to be widespread, to start later in life, or to cause night sweats. As a family physician, Dr. Mazzuca looks for these causes first, because treating the cause is the right first step when there is one.

How the treatment works

Sweat glands are switched on by nerves that release a chemical messenger called acetylcholine. In primary hyperhidrosis these nerves are overactive. A neuromodulator, the same family of medicine used to soften frown lines, blocks the release of acetylcholine where it is injected. Placed in many tiny amounts just under the skin of the affected area, it quietens the sweat glands in that area only.

The glands are not damaged or removed. Over months the nerve endings recover and sweating gradually returns, which is why the treatment is repeated. Because only the treated skin is affected, the body continues to cool itself normally everywhere else. The underarms account for a very small share of the body's total sweating, so treating them does not affect your ability to regulate temperature.

Hyperhidrosis treatment in Markham: what it treats

Areas treated at the clinic:

• Underarms (axillary hyperhidrosis), the most common and best-studied area. Treatment is quick and very well tolerated.
• Palms (palmar hyperhidrosis), for people whose hands drip during handshakes, writing, typing or using touchscreens. This area is more sensitive and needs extra attention to comfort.
• Soles (plantar hyperhidrosis), for sweaty feet that cause slipping, odour, damaged shoes or skin problems. The soles are also more sensitive to inject.
• Other focal areas, such as the forehead or scalp line, in selected cases after assessment.

Whether a particular area is suitable, and how much product it needs, is decided at your assessment.

Who it suits, and who should wait

Good candidates are adults with focal sweating of the underarms, hands or feet that interferes with daily life, at work, socially or with clothing, and who have not had enough relief from clinical-strength antiperspirants. Doctors often use a simple four-point scale, the Hyperhidrosis Disease Severity Scale, to describe how much sweating gets in the way. People who say their sweating is barely tolerable or intolerable and frequently interferes with daily activities are the ones most likely to benefit.

Before treating, Dr. Mazzuca asks when the sweating started, where it happens, whether it occurs at night, and what medications you take. Sweating that is generalised, new in adulthood, one-sided, or comes with night sweats, weight loss or fever needs a medical work-up first rather than injections.

Dr. Mazzuca will review your history and may postpone or advise against treatment if you:

• are pregnant or breastfeeding;
• have an infection, rash or broken skin in the area to be treated;
• have a neuromuscular condition such as myasthenia gravis, ALS or Lambert-Eaton syndrome;
• have had an allergic reaction to a botulinum toxin product before;
• take certain medications that can interact, such as aminoglycoside antibiotics;
• rely on fine hand strength for work or sport (for palm treatment, timing may need planning around temporary grip weakness).

What the appointment is like

1. Assessment. Dr. Mazzuca reviews your history, rules out secondary causes, confirms which areas to treat and explains the expected cost and timeline before starting.
2. Mapping. For underarms, a starch-iodine test is often used: iodine is painted on the skin and dusted with starch, which turns dark wherever sweat is active. This shows exactly where to inject. The area is then marked in a grid.
3. Comfort. Underarm injections feel like quick, small pinches and rarely need numbing. Palms and soles are more sensitive, so ice, vibration, topical numbing or other comfort measures are used as appropriate.
4. Injection. Many very small injections are placed just under the skin across the mapped area. Underarms take only a few minutes per side; hands and feet take longer.
5. After. The marks are cleaned off, you receive written aftercare, and a follow-up is offered to check the response.

The visit is booked for 30 minutes. There is no downtime, and most patients go straight back to work. Tiny bumps at the injection points settle within about half an hour.

When it works and how long it lasts

Most patients notice less sweating within two to four days, and the full effect is usually reached by about two weeks. For the underarms, relief commonly lasts four to twelve months, often around six months, and some patients go longer. Palms and soles tend to wear off sooner than the underarms. When sweating starts to return, you can book again; most patients settle into one or two treatments a year for the underarms.

The aim is a large, practical reduction in sweating, not complete dryness, and responses vary from person to person. If an area is under-treated, it can be reviewed at follow-up.

Side effects and risks

Treatment has a well-established safety record when it is performed by a physician. Common, temporary effects include:

• small bruises, redness or tenderness at the injection points;
• mild discomfort, especially after palm or sole treatment;
• a mild headache or flu-like feeling in the first day or two, which is uncommon.

After palm treatment, some patients notice temporary weakness in the small muscles of the hand, which can affect fine grip or pinching for a few weeks. After sole treatment, the feet can feel tender to walk on for a day or two. Some people feel they sweat a little more in other areas; this "compensatory sweating" is far more associated with surgery for hyperhidrosis than with injections. Spread of toxin effect beyond the injection site is a labelled warning for all botulinum toxin products and is rare at these doses. Serious allergic reactions are very rare.

Contact the clinic if you notice anything unexpected. Dr. Mazzuca assesses and manages any concern herself.

Aftercare

• Do not rub or massage the treated areas for 24 hours.
• Skip strenuous exercise, saunas, hot yoga and hot tubs for 24 hours.
• For underarms, it is usually best to wait until the next day to apply antiperspirant or deodorant and to shave.
• Showering normally is fine; pat the area dry.
• If you bruise, a cold compress helps, and bruises fade within about a week.
• Note the date your sweating starts to return, so the next treatment can be timed well.

To reduce bruising, avoid aspirin, ibuprofen, fish oil, vitamin E, ginkgo and alcohol for a few days beforehand unless a physician has prescribed them.

How it compares with other options

Hyperhidrosis treatment usually follows a ladder, starting with the simplest option and moving up only when it is not enough.

Option	How it works	Good for	Trade-offs
Clinical-strength antiperspirant (aluminum chloride)	Plugs sweat ducts at the surface	Mild to moderate underarm sweating; often tried first	Can irritate skin; needs regular use
Iontophoresis	A mild electrical current through water	Palms and soles	Several sessions a week at first, then maintenance; a home device is an option
Oral medications	Reduce sweating throughout the body	Widespread or multi-area sweating	Dry mouth, blurred vision and other side effects; not suitable for everyone
Neuromodulator injections	Block the nerve signal to sweat glands in one area	Underarms, palms, soles	Temporary; repeated every several months
Surgery	Cuts or removes the sympathetic nerve chain or glands	Severe cases that fail other options	Permanent; risk of compensatory sweating elsewhere

The same medicine is used cosmetically for frown lines, forehead lines and crow's feet and medically for chronic migraine, each with its own dosing and technique. If you already see Dr. Mazzuca for one, ask about the others at your visit.

Why patients choose a physician

At this clinic the person assessing you and the person treating you are the same person, and that person is a licensed physician. Dr. Mazzuca is an MD with CCFP certification in family medicine and additional training in cosmetic medicine, facial anatomy, women's health, and longevity medicine. Treatment is not delegated.

Her stated approach is to emphasise "subtle, elegant results that refresh rather than transform, using the least invasive treatments necessary to achieve safe, natural, and lasting outcomes."

For hyperhidrosis this is especially relevant. Excessive sweating is sometimes the first sign of another medical issue, from a thyroid problem to a medication side effect, and a family physician is trained to look for that before treating the symptom. Dr. Mazzuca can also provide the documentation many insurers ask for when they consider coverage.

Booking, pricing and what happens next

Step	What it involves	Cost
1. Consultation	Facial and skin assessment, discussion of goals, customized plan	$50 (30 min)
2. Virtual option	Video consult if you are outside the Markham area	$20 (15 min)
3. Excessive Sweating	Treatment performed by Dr. Mazzuca	from $400 (30 minutes)

All appointments are booked online through the clinic's booking system, where current availability and pricing are shown before you confirm.

Treatment is from $400 at the clinic. The final cost depends on the area or areas treated and the amount of product needed, which Dr. Mazzuca confirms before starting. As an illustration only, a patient treating the underarms once or twice a year at the starting price of $400 would budget from about $400 to $800 a year; palms and soles, or more than one area, cost more.

Hyperhidrosis is a medical condition, and some private insurance plans cover part of the cost of treatment, often only after other treatments have been tried and with a prior authorization form. Coverage varies widely, so check with your plan before your visit. OHIP does not cover this treatment at the clinic.

Serving Markham and the Greater Toronto Area

The clinic is located at 200 Cachet Woods Court, Suite 309 in the Cachet Woods area of Markham, near Woodbine Avenue and Major Mackenzie Drive, with parking on site. Patients travel from Unionville, Richmond Hill, Vaughan, Aurora, Stouffville, Thornhill, North York, Scarborough and the wider GTA. If you are outside the area, a virtual consultation is available before you commit to an in-person visit.

Frequently asked questions

Sources and further reading

• International Hyperhidrosis Society: patient information on diagnosis and treatment options
• Canadian Hyperhidrosis Advisory Committee, comprehensive approach to the recognition, diagnosis and severity-based treatment of focal hyperhidrosis.
• BOTOX (onabotulinumtoxinA) Canadian Product Monograph: warnings and adverse reactions (AbbVie Canada).
• College of Physicians and Surgeons of Ontario, public register, for verification of Dr. Mazzuca's registration.

Every treatment on this page is booked through Dr. Mazzuca's secure online system. New patients begin with a consultation; returning patients can book the treatment directly.

Written and medically reviewed by Dr. Monique Mazzuca, MD, CCFP. Last reviewed 2026-08-07.

This page is general information, not medical advice, and it is not a substitute for an in-person assessment. Results vary between patients, and every treatment carries risks that are reviewed with you before you consent. Suitability is determined by Dr. Mazzuca at your consultation.

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