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Objectives: This presentation will cover the aethiology, the therapy and the prognosis of the different types of focal essential hyperhidrosis and secondary generalised hyperhidrosis respectively. A special focus is the treatment with botulinum toxin in differnt areas and the anesthesia after Kreyden for palmoplantar injections with botulinum toxin Introduction: With an incidence of 5-8 % hyperhidrosis (dark figures is believed to be high) is a common disorder of the autonomic nervous system with onset mainly in puberty. Most cases are hereditary with a positive family history. We distinguish primary focal from secondary generalised HH. Materials / method: Treatment of first choice for the primary form is botulinum toxin after local application of aluminum salts has been exhausted. For the palmoplantar HH the therapy of choice is the tapwater iontophoresis and if not effectfull or not faisable botulinum toxin injections. Secondary form is treated causally or symptomatically with medication. Results: This presentation will cover all the different therapeutic modalities with botulinum toxin in the treatment of the different localisation of HH. The correct application of the iontophoresis is presented. A special focus will be the anaesthesia after Kreyden for treating palmoplantar HH with botulinum injections. Conclusion: Botulinum toxin is the therapy of first choice in primary essential focal HH. However the correct treatment plan for excellent results is essential. This presentation will give an overview of the topic of HH and the different treatment prcudures including anaesthesia after Kreyden for palmoplantar HH