Focal hyperhidrosis may occasionally occur in other locations.
Not infrequently facial hyperhidrosis is limited to the upper or lower lip and / or to the nose wings. In these cases, the surgical block of the sympathetic nerve (interganglionic level T1-2) is not recommended, since, in addition to the side effects, it is significantly less effective than in hyperhidrosis that involves the entire face. Instead, infiltration of botulinum toxin have shown to control sweating for months (injections should be inoculated intradermally, i.e. as superficial as possible, in order to avoid weakening of the lip muscle).
Excessive sweating in the groin and / or intergluteale and / or in the perineum may often create embarrassment, as it can cause wet marks on underwear and pants to the degree that it could be interpreted as incontinence. Typically, in these intertriginous areas, botulinum toxin is more effective than treatment with antiperspirants.
It is characterized by unilateral sweating on either cheek overlying the parotid gland. The cause is usually traumatic or surgical (eg, results from operations for cancers of the gland). Sweating occurs after intake of food, especially spicy or acidic (gustatory sweating).
Infiltration of the skin with botulinum toxin has been proven to be the most suitable treatment, lasting on average 6-8 months (period that tends to increase after several applications).