Many people who complain of excessive sweating have primary hyperhidrosis. This idiopathic disorder is characterised by excessive, bilateral and roughly symmetrical sweating, most commonly affecting the axillae, palms, feet and face. For some patients, excessive sweating is intolerable as it stains and damages clothes, reduces confidence and limits social contact. Treatment options have been limited but now include botulinum toxin for severe axillary hyperhidrosis. Here we review treatments for primary focal hyperhidrosis, focusing on axillary sweating.