Migraine & Axillary Hyperhidrosis Treatment Clinic
The ByWard Family Health Team offers treatment for:
- Chronic migraine
- Axillary hyperhidrosis (excessive underarm sweating)
Chronic Migraine
The treatment offered through the clinic can help prevent migraines and reduce their frequency. It is typically recommended for patients who:
- Have 15 or more headache days per month
- Experience headaches lasting 4 or more hours per day
Treatment can significantly reduce the number and severity of migraine days.
Axillary Hyperhidrosis (Excessive Underarm Sweating)
Injection treatment can also be used to treat severe underarm sweating when other treatments, such as prescription antiperspirants, have not worked. The treatment works on the nerve signals that trigger sweat production.
Dr. Kieu Phung graduated from the Family Medicine Program at McGill University in 2000. She subsequently worked at the Neurocenter, Copenhagen University Hospital Rigshospitalet in Denmark, a highly specialized hospital recognized for treatment, research, and innovation in neuroscience.
Dr. Phung obtained a PhD in dementia epidemiology from the University of Copenhagen in 2009 and continued to conduct research in this field in Lebanon and the Philippines until 2019, when she returned to Canada to practise family medicine.
Dr. Phung has received specialized training in injection treatment for chronic migraine and now provides treatment for chronic migraine and axillary hyperhidrosis at ByWard Clinic, helping to improve access and reduce wait times for patients who may benefit from this therapy.
Dr. Phung speaks English, French, Danish, and Vietnamese.
A referral is required.
Referral Form:
Fax: 613-564-6627
Chronic Migraine
You may be eligible if:
- You experience 15 or more headache days per month
- Other causes of headache have been ruled out
- You have tried, or cannot tolerate, one to two preventive treatments
Axillary Hyperhidrosis
You may be eligible if:
- You experience excessive underarm sweating
- Your symptoms affect your daily life
- Topical treatments have not been effective
Injection treatment is not appropriate for everyone. You may not be eligible for treatment if you have any of the following.
Absolute Contraindications
You should not receive this treatment if you:
- Have a known allergy to botulinum toxin or any of the ingredients in the medication being used
- Have an active infection or skin condition at the injection site
- Have had a previous serious reaction to botulinum toxin or a similar treatment
Medical Conditions Requiring Caution
Treatment may not be appropriate, or may require further assessment, if you have:
- A neuromuscular disorder, such as myasthenia gravis, Lambert-Eaton syndrome, or amyotrophic lateral sclerosis (ALS)
- Difficulty swallowing or breathing
- Significant muscle weakness
You will meet with Dr. Phung to review your medical history and determine if treatment is appropriate.
If You Are Being Seen for Chronic Migraine
Dr. Phung will obtain your medical history and perform a neurological examination. If indicated, further testing will be arranged.
Once it has been established that you meet the treatment criteria, Dr. Phung will prescribe the appropriate medication and, where applicable, process your application for reimbursement through your private insurance company or through the Exceptional Access Program (EAP) of the Ontario Drug Benefit Program.
Once any required approval has been received, your injection appointment will be scheduled.
The recommended treatment schedule is generally every 12 weeks. Injections are administered into specific areas of the head and neck muscles used in chronic migraine treatment. The procedure is performed in the clinic.
If You Are Being Seen for Axillary Hyperhidrosis
Dr. Phung will review your symptoms, previous treatments, and medical history to determine whether injection treatment is an appropriate next step.
If indicated, treatment is administered by injection into the affected underarm area. The procedure is performed in the clinic, and patients can go home afterward.
Results are temporary, and repeat treatment may be required over time depending on your response.
Once you receive confirmation of your consultation appointment, you may be asked to complete a questionnaire. Please complete any requested forms before your appointment and bring your private insurance information with you.
For patients with axillary hyperhidrosis, it may also be helpful to bring:
- A list of previous treatments you have tried
- Details about how your symptoms affect your daily life
Migraine Treatment/Procedure – $150
Axillary Hyperhidrosis Treatment/Procedure – $150
Do I need a referral?
Yes. A referral from your healthcare provider is required for both chronic migraine and axillary hyperhidrosis treatment.
Is the treatment covered by OHIP?
The cost of the medication is not routinely covered by OHIP.
For chronic migraine, medication coverage may be available through:
- Private insurance
- Ontario Drug Benefit through the Exceptional Access Program (EAP)
For axillary hyperhidrosis, the medication cost is typically not covered and may need to be paid by the patient. Coverage may be available through some private insurance plans.
How long does the procedure take?
The injection procedure typically takes 15–20 minutes and is performed in the clinic.
Does the treatment hurt?
Most patients describe the injections as causing mild discomfort, similar to tiny pinpricks. The needles used are very small, and the procedure is quick.
How often do I need treatment?
- Chronic migraine: Generally every 12 weeks
- Axillary hyperhidrosis: Generally every 4–6 months, depending on your response
When will I see results?
- Chronic migraine: Improvement is usually seen within a few weeks
- Axillary hyperhidrosis: A reduction in sweating often begins within a few days to two weeks
Are there side effects?
Side effects are generally mild and temporary and may include:
- Injection-site discomfort
- Minimal bleeding
- Mild swelling or bruising at the injection sites
- Temporary muscle weakness, depending on the treatment area
- A vasovagal episode, during which heart rate and blood pressure drop, temporarily reducing blood flow to the brain. This can cause nausea, lightheadedness, and a feeling of being unwell. It typically resolves after lying flat for 5–10 minutes.
Serious side effects are rare and will be reviewed during your consultation.
What happens after the injections?
You can generally return to your normal activities immediately following treatment.
For chronic migraine, follow-up treatments are generally scheduled every 12 weeks.
For axillary hyperhidrosis, repeat treatment is based on the return of symptoms.
Do I need to prepare for my appointment?
- Bring your insurance information.
- Complete any required forms in advance.
- For axillary hyperhidrosis, avoid applying deodorant on the day of treatment if instructed.
What if I don’t qualify?
If the treatment is not appropriate for you, Dr. Phung will discuss alternative treatment options with you.
