Weight-loss jabs may rule these days when it comes to banishing unwanted body fat – but liposuction remains one of the most popular cosmetic surgery procedures.

Liposuction is used to syphon off fat, usually from the tummy or thighs. But experts are warning that the procedure – which can cost between £3,000 to £10,000 – is not always the permanent fix for fat problems that some patients expect it to be. Indeed, it can lead to a build-up of fat in other areas where it is potentially far more harmful.

The procedure is usually performed under a general anaesthetic, with a high-pressure water jet, laser or ultrasound device used to break up the fat cells – a suction device clears everything out. Side-effects, though rare, can include haematomas (bleeding under the skin), uneven results leaving lumps (where fat has not been removed evenly) and blood clots.

The emerging concern is that patients may not realise the long-term risks of removing the fat cells – particularly if they later gain weight. That’s because the human body tightly regulates the number of fat cells it has. If a fat cell dies, it’s replaced with a new one but if it’s surgically removed then it isn’t. So if we subsequently gain weight, existing fat cells elsewhere on the body just get larger.

The procedure physically removes large numbers of fat cells and destroys the underlying support structure, so these fat cells don’t regrow in this area once they are removed.

However, the body then compensates for their loss by depositing more fat in the existing cells in other areas, so they get bigger.

‘When we remove fat with liposuction, that’s permanent because we are removing fat cells,’ says Nora Nugent, a consultant plastic surgeon at the Purity Bridge Clinic in Tunbridge Wells, and president of the British Association of Aesthetic Plastic Surgeons.

‘So if you later gain weight, the fat cells in other parts of the body get bigger. For example, if you had liposuction on your tummy and then gained weight the fat might build up on your thighs or hips.

Liposuction is used to syphon off fat, usually from the tummy or thighs. But experts are warning that the procedure is not always the permanent fix that some patients expect it to be

‘This is one reason why we always stress to patients that liposuction is not a weight-loss therapy – it’s a tool for body contouring.

‘There is a misconception that it’s a weight-loss procedure – in fact, an ideal candidate is someone who is a healthy weight but has unwanted fat in a particular area.’

What’s even more concerning than fat returning after liposuction is the risk that it gets stored as visceral fat – the type stored deep inside the abdomen close to vital organs such as the liver, pancreas and intestines.

Visceral fat plays a crucial role in protecting these organs against injury, but the body only needs a small amount. In excess, it starts to release hormones and inflammatory chemicals that raise the risk of type 2 diabetes, heart disease and high blood pressure.

Liposuction removes subcutaneous fat, which lies just beneath the skin, but it cannot access visceral fat. Even in patients who do not gain weight after liposuction, levels of visceral fat can increase, according to a 2012 study published in the Journal of Clinical Endocrinology & Metabolism.

It tracked 36 women of a healthy weight and found that, while the liposuction successfully removed their tummy fat, over the following six months they each saw a 10 per cent increase in visceral fat levels.

The Brazilian researchers said this was a ‘compensatory increase’ – a physiological response where the body stores fat around the internal organs when it detects there has been a sudden and marked decline in levels of subcutaneous fat. In other words, it conserves energy to ensure survival.

Professor Tunc Tiryaki, a consultant plastic surgeon at The Cadogan Clinic in London, says not everyone who has liposuction necessarily gains more visceral fat.

‘You don’t just gain visceral fat by gaining weight,’ he told Good Health. ‘It’s more to do with whether you already have underlying health issues, such as type 2 diabetes or insulin resistance [a forerunner to type 2 diabetes].

‘In these people, fat is more likely to accumulate in the visceral area.’

The Brazil study did have some good news, however – women who exercised daily in the four months after liposuction saw no increase in their visceral fat levels.

Ms Nugent says the key to avoiding further fat problems is to ensure you don’t gain significant weight after liposuction.

‘If you do, the fat has to go somewhere,’ she says.

And for all its popularity, liposuction should not be thought of as a minor procedure, she adds.

‘It’s a safe treatment but patients still need to think of it as surgery.

‘It may only involve small incisions – no more than 1cm long – but people don’t realise how much work is involved under the surface.’

Could the Burmese python hold the secret to weight-loss jabs that are free of side effects? That’s the hope of research into the reptile’s remarkable ability to suppress its appetite.

While the snakes can swallow their own bodyweight in one sitting, they are also able to go for months without touching a single meal.

US scientists have now identified the key to their appetite control.

After feasting, they produce a chemical in their gut that suppresses any desire in their brains to eat more. Researchers believe this finding could lead to a new generation of alternatives to weight-loss drugs such as Wegovy, Ozempic and Mounjaro – crucially, without side effects such as nausea.

It’s one of a slew of new medical hopes emerging from studies of snakes that promise to help with everything from chronic pain to breast cancer.

But it is the potential of snakes to assist with weight loss that is generating some of the greatest excitement.

The idea is being explored by researchers at Stanford Medicine and the University of Colorado, who found that after digesting a meal a Burmese python’s gut produces a 1,000-fold increase of an appetite-suppressing chemical called para-tyramine-O-sulphate (pTOS).

This chemical is believed to send sensations of fullness to their brains after eating – and scientists now hope that it may be used to block hunger pangs in obese people.

After feasting, Burmese pythons produce a chemical in their gut that suppresses any desire in their brains to eat more

A report in the journal Nature Metabolism earlier this year showed how, after a meal, pTOS is generated in the python’s gut and liver, then travels to the hypothalamus in the brain, where it ‘activates neurons involved in regulating feeding behaviour’.

When scientists injected obese mice with pTOS daily for a month, the rodents lost nearly a tenth of their bodyweight. Further investigations suggested that pTOS is produced by bacteria in the python’s gut as a byproduct when breaking down food. Tellingly, when the research team knocked out the snakes’ gut bacteria with antibiotics, pythons no longer had post-meal surges of pTOS.

The hope is that pTOS could produce the same magic in humans.

Weight-loss jabs currently available work by mimicking the effect of glucagon-like peptide-1 (GLP-1), a hormone produced in the pancreas and by cells in the gut which briefly regulates appetite after a meal and slows the transit of food through the gut.

But they can cause problematic side effects, particularly nausea, vomiting, diarrhoea, and constipation, fatigue and muscle loss.

Yet none of these problems were seen in lab mice dosed with pTOS, according to the report in Nature Metabolism.

One of the study’s authors, Dr Yong Xu, a behavioural neuroscientist, said that now we ‘know that pTOS clearly suppresses feeding’, his team will investigate how pTOS changes the brain, to see if new drugs can be identified to use as appetite suppressants.

The study also found that humans have pTOS in their blood, but at much lower levels. And the researchers discovered that, in most samples, it rose slightly after a meal.

Interestingly, one individual showed a 25-fold increase, hinting that some lucky people among us may have actually developed stronger, python-like responses.

GLP-1 drugs were themselves inspired by another reptile – the venomous Gila monster lizard.

During long periods of starvation, Gilas are able to slow their metabolisms and maintain constant blood sugar levels, so they don’t die of hunger.

Thirty-five years ago Dr John Eng, an endocrinologist in New York, discovered the chemical in Gila monsters’ saliva that enabled them to do this.

He called it exendin-4 and realised that it was similar to GLP-1 in humans. In the wake of this, drug companies worked to create GLP-1 drugs.

Snakes – and their venom in particular – have already led to the development of many life-saving medications.

For example, angiotensin-converting enzyme (ACE) inhibitors, one of the most commonly prescribed drugs for high blood pressure, are based on the action of the South American pit viper.

People bitten by this snake suffer such a dramatic drop in blood pressure that they lose consciousness. In the 1960s, scientists discovered this is due to chemicals in the venom that prevent our bodies making a hormone called angiotensin-2, which narrows blood vessels. Blocking angiotensin-2 makes blood vessels relax, which lowers blood pressure as the vessels dilate.

This finding led to the development of ACE inhibitors – now 65 million prescriptions for them are written every year in the UK.

Meanwhile, tirofiban, a widely used anti-clotting drug, is derived from one of the world’s deadliest snakes: the saw-scaled viper.

Its venom causes catastrophic haemorrhages and victims bleed to death. In 1987, scientists isolated a chemical from the venom, called echistatin, which prevents human blood platelets sticking together and clotting.

Tirofiban is used to prevent clots forming in the arteries of patients’ hearts in the wake of heart attacks, or while people are having surgery to treat a blocked coronary artery.

Venom is believed to have so much potential medically that in February scientists at King’s College London announced a £2.6million project to use artificial intelligence to scan venoms for substances that may have medical benefits for humans.

Already new uses are on the horizon, with therapies for breast cancer and chronic pain, according to a 2024 report in the journal Medicine In Drug Discovery.

An enzyme in the venom of the horned desert viper can stop breast tumour cells spreading around the body and lodging in tissues by preventing them from using proteins as glue, the study authors revealed.

Another enzyme in the venom stops tumour cells growing blood vessels which are needed to feed their growth.

The same study also suggested that venom from the South American rattlesnake may ease chronic pain. A nerve poison called crotoxin has been isolated from the venom and has been found to alleviate severe pain in patients with cancer.

And in Malaysia, researchers found that snake venom may provide a weapon against antibiotic-resistant bacteria such as MRSA.

Snake venoms contain substances that kill bacteria, for example, by breaking up their protective membranes and destroying the proteins they are built from, according to research at Kebangsaan University in Kuala Lumpur, published in the journal Toxins in 2025.

Snakes have these bacteria-killing powers to protect themselves from being infected by bugs found in their victims’ blood.

‘The toxins in some snake venoms are very good at killing cells in bacteria and viruses,’ Professor Nick Casewell, director of the Centre for Snakebite Research and Interventions at Liverpool School of Tropical Medicine, told Good Health.

‘This could make them effective antibiotic or antiviral medicines.

‘Unfortunately, these snake venoms are also very good at killing human cells as well, which is the problem here.’

The Centre for Snakebite Research and Interventions features the UK’s only Home Office-accredited snake research facility. It houses the largest, most diverse collection of tropical venomous snakes in the UK, with more than 50 species.

The venom they provide underpins research into new anti-venom treatments.

Better anti-venoms are desperately needed worldwide, with snakebites killing around 100,000 people per year, and around four times that number experiencing life-changing injuries such as kidney failure, muscle damage that can lead to limbs being amputated, and paralysis.

In the quest for effective snakebite therapy, one man in the US has injected himself with snakes’ venom more than 850 times.

Since 2001, Tim Friede, a truck mechanic and amateur snake enthusiast, has been injecting himself with low doses of venom in a bid to build up immunity from the lethal snakes he began collecting as a schoolboy. He claims that he has since survived being bitten more than 200 times by many different species.

Now his alarming self-protection strategy could lead to better treatments for snakebites.

When scientists at Columbia University injected antibodies from his blood into mice, they protected the rodents from 13 of 19 medically important snake venoms – those with medical applications – according to a report in the journal Cell last year.

It is hoped that future work using antibodies derived from a human can avoid the risk of severe allergic reactions.

Current anti-venoms are made by injecting horses and sheep with low-dose snake venoms and harvesting their antibodies, but these can trigger life-threatening immune reactions in people, which limits their use to well-equipped hospitals.

Professor Casewell’s team is hoping to take anti-venom treatments to a first-aid level.

They are working on a drug that can save people’s lives regardless of the type of snake that bit them.

Different venoms have been analysed to find a common feature that could be blocked by a single drug. They now have two promising antidotes that will start human trials soon.

‘These are existing drugs that have already been passed as safe in humans for other uses,’ he said. ‘One has been used to treat heavy-metal poisoning. The other is a cancer drug that was shown in trials to be safe, but didn’t show sufficient efficacy so it’s never been used.

‘One very promising thing is that these are oral treatments.’

Two tick species that carry dangerous pathogens are thought to be invading new counties in a New England state, raising concerns that millions more people may be at risk of disease.

Connecticut has historically not been an established home for lone star ticks – typically found in southern states – or Asian longhorned ticks – typically found in the Northeast and mid-Atlantic regions. 

However, both species have now been discovered in several different areas across southern Connecticut, including New Haven, Fairfield and New London, especially in Waterford. 

A bite from either tick can spread Ehrlichiosis, a bacterial illness that causes flu-like symptoms, including fever, headache, muscle aches, and fatigue. If left untreated, it can cause kidney, lung or heart failure, respiratory distress, seizures or a coma.

Lone star ticks are also capable of spreading alpha-gal syndrome (AGS), which causes a potentially life-threatening allergy to a molecule found in beef, pork and dairy. 

People who develop AGS can have a dangerous allergic reaction to these foods and require immediate medical care. 

Dr Goudarz Molaei of the Connecticut Agricultural Experiment Station called the presence of both ticks ‘a perfect storm.’ 

A researcher in Maine displays lone star ticks in a vial. Typically, this type of tick is found in Texas and Oklahoma

Pictured above is a female lone star tick, which can transmit Ehrlichiosis, a bacterial illness that causes flu-like symptoms

He told local news outlet WTNH: ‘Both ticks are transmitting one disease, both ticks are feeding on white-tailed deer, and there’s the possibility that there’s an exchange of the disease agent between the two tick species.

‘Having these two tick species side-by-side is a perfect storm.’ 

People who live in these counties, especially in communities close to the coast, should be on high alert and keep an eye out for ticks.

A warming climate, wildlife migration and environmental destruction is driving the spread of ticks to new areas in the US. 

Last year, a rare bacterium that causes a more severe form of Lyme disease was found in New York for the first time. 

A resident of Herkimer County, New York, located in the central part of the state, tested positive for Borrelia mayonii last year, according to a June CDC Morbidity and Mortality Weekly Report. 

Prior to that case, the pathogen had only ever been detected in people in Minnesota and Wisconsin.

Additionally, a new case of a rare tick-borne disease was detected in a human for only the fourth time on record in California earlier this year. 

A resident tested positive for the bacteria Rickettsia lanei, marking the third human case in the state and the fourth human case worldwide since the bacteria was first identified eight years ago. 

In an April CDC report, the agency warned that emergency department visits due to tick bites were at their highest level since 2017, which may foreshadow an especially severe season ahead for Lyme disease and other tick-borne illnesses.

The data showed there were 71 visits for tick bites per 100,000 people – more than double the average of about 30 per 100,000 for that time of year.

According to that data, the Northeast had the highest rate per population – at 163 tick-related ED visits per 100,000 people, up from just 52 in March. That already outpaced recent full-year highs in the region, which ranged from 74 to 89 per 100,000 between 2021 and 2025.

Ticks reside in grassy, brushy and wooded environments and spread disease by biting into the skin and feeding on blood. They should be removed as soon as possible, which can be done by using tweezers to gently grasp the tick close to the skin

For hospital visit rates – the Northeast also leads the nation, with 104 emergency visits for tick bites per 100,000 emergency trips, according to data updated June 21. 

This was followed by the Midwest with 75 ED visits per 100,000 trips; the Southeast had 34 visits per 100,000 trips; the West had 21 visits per 100,000 trips; and the South Central had 12 visits per 100,000 trips.

There was a similar spike in ED visits due to tick bites last year, though it didn’t occur as early. That surge occurred in July, when tick-related hospital visits reached 127 per 100,000 ED visits — the highest July level since 2017. 

Ticks reside in grassy, brushy and wooded environments and spread disease by biting into the skin and feeding on blood.

As they feed, they pump saliva loaded with bacteria, viruses or parasites directly into the wound.

The longer a tick stays attached, the more infectious pathogens enter the body. Most ticks need 24 to 48 hours to transmit enough bacteria to cause illness, but some dangerous viruses can infect someone in just 15 minutes.

Ticks should be removed as soon as possible, which can be done by using tweezers to gently grasp the tick close to the skin.

Avoid squeezing the tick tightly during removal, as this may increase the risk of infection.

Around 31 million Americans experience a tick bite every year and nearly 476,000 of them end up with Lyme disease, the most common tick-borne illness.

From heat stroke to dehydration, soaring temperatures don’t come without risk. 

Most of us will know that getting sunburnt can increase the risk of skin cancer – but now experts say it could be behind a health condition suffered by millions: tinnitus. 

It is not uncommon for your ears to ring after attending a concert or loud party, but for those with tinnitus, the ringing is constant. 

But this effect doesn’t have an external source – rather it is caused by the perception of a sound in the ear. 

When the brain can’t locate a specific sound, it compensates by increasing neural activity, which is believed to cause the perception of sound when none exists. 

This hyperactivity can also interfere with the brain’s natural filtering mechanisms – just like sunburn. 

‘Sunburn is one of the things that doesn’t just feel painful and uncomfortable, but it can also have a big impact on our ear health,’ Kayleigh Waters, an audiologist at Boots Hearing Care explains. 

‘While sunburn is primarily a skin issue, leading to an increased risk of skin cancer, it can also exacerbate symptoms of tinnitus.’

Tinnitus is thought to affect around one in ten people, and can be made worse or brought on by sunburn  

With scorching summers set to become the norm in the UK, experts have warned that cases of melanoma – the deadliest form of skin cancer – could climb to 26,500 a year by 2040.

And with it, we could see a sharp rise in the number of people experiencing tinnitus. 

‘Intense sun exposure often leads to inflammation, which is known for worsening tinnitus,’ Waters said. 

‘Not only this, but sunburn can cause physical stress and dehydration, both of which are factors that can lead to heightened tinnitus symptoms.’ 

A lack of proper fluid intake can also affect the inner ear, disrupting the normal balance of fluid the inner ear relies on for hearing and balance. 

‘When the body becomes dehydrated, it can disrupt this fluid balance, potentially leading to symptoms such as ringing in the ears, dizziness, a feeling of fullness, and even muffled hearing.’ 

As such, while the NHS recommends drinking six-to-eight glasses of fluid a day, the audiologist recommends increasing this to up to 10 during warmer periods to prevent dehydration. 

The good news is, it’s possible to minimise the risk of sunburn-induced tinnitus.

‘Mitigating this is as simple as taking steps to prevent sunburn, such as wearing and reapplying SPF, not spending extensive periods in direct and intense sunlight, as well as covering up when necessary with wide-brimmed hats and suitable clothing,’ Waters said. 

An estimated 750 million people globally are thought to suffer from the condition that causes ringing, buzzing, hissing or roaring sounds in one or both ears. 

Other common triggers include ear infections, earwax build-up, or Meniere’s disease – a chronic inner-ear condition that can also trigger vertigo. In these cases, treating the cause often provides relief. 

But for about 1.5 million people, the condition is long-term, difficult to tackle and has a significant impact on daily life.

As such, current treatments focus on helping patients better cope with the symptoms – using cognitive behavioural therapy and white noise to drown it out. 

But with temperatures expected to reach sweltering highs this week – exceed 39C in some parts of the country – staying safe in the sun can also help minimise your risk. 

NHS guidance recommends limiting time in direct sunlight – especially during the middle of the day when the sun is at its strongest – and applying sunscreen, with at least SPF 30 and a four UVA rating, regularly. 

And even if you have already suffer from constant ringing, it is never too late to start protecting your ears, as well as your skin. 

Sweating is one of those bodily functions we don’t tend to think much about until it starts causing problems.

Most of us expect to perspire after a workout or when we’re trapped on a packed train with the heating inexplicably set to tropical rainforest levels.

Or, of course, during a heatwave. At this time of year, but especially during the current heatwave, most people will sweat more as warmer temperatures trigger the body’s cooling mechanisms.

When our internal temperature rises, whether because of exercise, hot weather, fever, stress, spicy foods or hormonal changes, a part of the brain called the hypothalamus, which acts as the body’s thermostat, sends signals via the nervous system to sweat glands in the skin, causing them to release sweat.

As the sweat evaporates from the skin’s surface, it takes heat energy away with it, helping to cool the body down.

It’s an elegant system that has served humans remarkably well for thousands of years.

Although it does struggle when it’s humid. Because there is already more moisture in the air, sweat evaporates less efficiently from the skin. This makes it harder for the body to lose heat, leaving you feeling hotter and stickier. In these conditions, it can help to cool the body more directly by using cool water sprays, taking lukewarm showers, staying well hydrated, slowing down and avoiding direct sun during the hottest parts of the day.

Dr Raj Arora says she regularly meets patients who are embarrassed by excessive sweating

In some people, however, the body’s natural cooling system becomes a little overenthusiastic. It’s a bit like having a smoke alarm that sounds every time somebody makes toast. For them, sweating is a daily frustration, appearing at inconvenient moments and in quantities that seem entirely disproportionate to the situation. And this hot weather can make an already troublesome problem feel significantly worse because the body’s normal cooling response is being added to an already overactive sweating system.

It can have a major impact on people’s lives.

As a GP, I regularly meet patients who are embarrassed by excessive sweating.

Some avoid shaking hands because their palms are constantly damp. Others stick to black clothing year-round to disguise underarm patches. Many have spent years assuming they simply have to live with it. It’s often only when they start talking about it that they realise just how much it has affected them. They may avoid social events, worry constantly about visible sweat marks, decline opportunities involving public speaking or become anxious about close personal contact. Something as simple as signing a document can become stressful if the paper ends up damp by the time they’ve finished.

Understandably, this can take a toll on confidence and wellbeing.

Some fear their excessive sweating is caused by poor hygiene and become overly concerned about staying clean. Others see it as a sign of weakness or assume they are simply an anxious person.

The reality is that excessive sweating, known medically as hyperhidrosis, is a recognised condition, thought to result from overactivity in the nerve signals that stimulate sweat glands, and there are treatments available that can make a significant difference.

The key distinction between sweating and hyperhidrosis is that sweating serves a purpose.

Hyperhidrosis occurs when the body produces significantly more sweat than is necessary for temperature regulation. The sweating often occurs without any obvious trigger.

It is surprisingly common. Studies suggest that around 2 to 5 per cent of the population are affected, with men and women affected in broadly similar numbers, although women may be more likely to seek medical advice.

In many cases, the sweating is localised to specific areas such as the hands, feet, underarms or face. These areas contain particularly high concentrations of eccrine sweat glands, which are responsible for most of the body’s temperature-regulating sweat. The palms and soles are especially rich in these glands, which helps explain why they are commonly affected.

As a general rule, it’s worth speaking to your GP if sweating is affecting your quality of life or interfering with work or social situations

In others, excessive sweating affects much larger areas of the body.

It’s thought the problem lies not within the sweat glands themselves but with the nerve signals controlling them. Certain groups of sweat glands appear to receive disproportionately strong stimulation from the nervous system.

There is also a psychological component. Stress, anxiety and embarrassment naturally trigger sweating because the body’s fight-or-flight response activates sweat glands, particularly in the palms, soles and underarms. This response evolved to improve grip and prepare the body for action in stressful situations.

Unfortunately, this can create a vicious cycle. Someone becomes anxious about sweating. That anxiety causes more sweating. And so the cycle continues.

The most common form of the condition is known as primary hyperhidrosis. This usually begins during childhood or adolescence and affects otherwise healthy individuals, and often runs in families. This type appears to involve overactive nerve signals between the brain and the sweat glands.

With secondary hyperhidrosis, the excessive sweating is caused by another medical condition or medication and is often linked to underlying problems affecting temperature regulation or hormone levels.

Conditions such as an overactive thyroid gland, diabetes, infections, obesity, neurological disorders and hormonal changes associated with menopause can all contribute. Certain medications can also increase sweating. Common culprits include antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), some painkillers such as opioids, medications used for diabetes and certain treatments for high blood pressure.

Unlike primary hyperhidrosis, secondary hyperhidrosis often causes more widespread sweating and may be particularly noticeable at night, as the underlying conditions responsible, such as infections, hormonal fluctuations or certain cancers, can affect temperature regulation during sleep.

Conditions such as an overactive thyroid gland, diabetes, infections, obesity, neurological disorders and hormonal changes associated with menopause can all contribute to sweating

This is why it’s important not to dismiss excessive sweating.

While the vast majority of cases are not caused by anything serious, a sudden change in sweating patterns, particularly if accompanied by symptoms such as weight loss, persistent fevers, palpitations or drenching night sweats, should be assessed by a healthcare professional.

As a general rule, it’s worth speaking to your GP if sweating is affecting your quality of life, interfering with work or social situations, waking you at night, or if it has developed suddenly later in life.

Many assume ordinary antiperspirants simply don’t work for hyperhidrosis. In reality, standard products are often not strong enough rather than being ineffective altogether.

Fortunately, treatment options have improved considerably.

For many people, the first step is using a prescription-strength antiperspirant containing aluminium chloride. These products work by temporarily blocking sweat ducts and can be highly effective, particularly for underarm sweating.

Certain medications known as anticholinergics can reduce sweating by blocking the nerve signals that stimulate sweat glands.

While effective for some, anticholinergic medications are not suitable for everyone, particularly people with certain types of glaucoma or urinary retention problems, as they can worsen these conditions. They can also cause side-effects including dry mouth, constipation, blurred vision and difficulty passing urine.

Iontophoresis sounds like something devised by a maverick Victorian scientist, but it has been used safely for decades

Some patients benefit from iontophoresis. This involves placing the hands or feet in shallow trays of water while a very mild electrical current passes through. It sounds like something devised by a maverick Victorian scientist, but it has been used safely for decades and can work remarkably well for sweaty hands and feet. It appears to temporarily disrupt the signals between nerves and sweat glands and may also reduce sweat production by altering sweat duct function.

The main drawback is that regular maintenance treatments are usually needed to sustain the benefits, often every one to two weeks, although this varies considerably between individuals.

Availability varies across the NHS and home devices typically cost several hundred pounds.

Botulinum toxin injections can also be highly effective, again temporarily blocking the nerve signals to the sweat glands.

For people with troublesome underarm hyperhidrosis, the results can be impressive. Many notice a significant reduction in sweating within a couple of weeks and the effects often last between four and 12 months before treatment needs repeating. In some parts of the UK, botulinum toxin treatment may be available through specialist NHS services.

Surgery may be an option for severe cases where symptoms significantly impair daily functioning.

The most common procedure, endoscopic thoracic sympathectomy, or ETS, involves interrupting specific nerves within the chest that stimulate sweating in the hands and sometimes the underarms. It can be highly effective, particularly for severe palmar hyperhidrosis, but it carries risks, including compensatory sweating, where excessive sweating develops elsewhere on the body after surgery.

This is why surgery is usually considered only when all other options have been exhausted.

In my experience, most patients find meaningful improvement long before surgery ever becomes necessary.

The most important message is that excessive sweating is absolutely nothing to be embarrassed about. It’s simply the result of sweat glands receiving signals they don’t necessarily need, and it’s something that can often be improved.

So if you find yourself carrying spare shirts, strategically choosing clothing colours based on sweat visibility, or greeting people with an apologetic warning about your handshake, speak to your GP.

Dr Arora is an NHS GP based in Surrey.

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