It’s said that about 1% of the population has hyperhidrosis (the technical term for excessive sweat), a condition in which the body produces extra sweat. Generally, it begins during adolescence but can start at any age and continue throughout our lifetime effecting areas such as the face, hands, armpits, feet, trunks and thighs; sweating can occur at random throughout the day along with night sweats.
Excessive Sweating is a serious matter, especially when it occurs in front of others. Simply hiding your condition from others can cause a great deal of emotional distress which in turn increases the amount of sweat produced thereby creating even more stress!
Stop the embarrassment, hassle and expense of excessive sweating.
For excessive underarm sweating the easiest treatment is Botox. A single treatment to both underarms will reduce sweat production by an average of 83.5% and last on average for 7.5 months.
Treatment Options for Sweating
- Antiperspirants – High strength antiperspirants such as Hidrosol are available at chemists or the newer Rexona range from the supermarket. US antiperspirants are a little stronger than what we are used to in NZ and can be quite effective. They contain a higher concentration of Aluminium salts than usual antiperspirants. Aluminium salts bind dead skin cells to form plugs which block the sweat pores. They are best applied to dry skin after a shower. The higher concentration products may irritate the skin. There is a limit to how much they can help.
- Oral Drugs – These are available from a doctor. Oxybutinin, beta blockers, diltiazem and propantheline can reduce sweat production. They have side effects especially dry mouth.
- Iontophoresis – This treatment involves a mild electric current passed through water applied to the skin. Regular treatments are necessary. A full size machine is available at some hospital dermatology clinics.
- Surgery – There are two types of surgery used to treat hyperhidrosis:
- Currettage involves cutting and scraping away the sweat glands. This leaves a large wound which then needs a skin graft or heals with a large scar.
- Endoscopic thoracic sympathectomy is more commonly performed. It involves telescopic surgery to cut the nerves inside the chest which control sweating. This is done through a number of small incisions made between the ribs. It works extremely well for palmar sweating, less so for the armpits where not everyone gets excellent results. Compensatory sweating (new areas of excessive sweating occurring in new body areas) can occur in about 30% of patients.
- Botox® – Botox® is a purified form of Botulinium toxin. Botox® blocks the nerve signal which stimulates the sweat glands. The neurotransmitter involved, acetyl choline, is the same neurotransmitter which stimulates muscle contraction. Botox reduces excessive sweating.
Medical studies show that the average reduction in sweating has been shown to be 83.5%. The effects last an average of 7.5 months. Sweating slowly increases again and eventually the treatment will need to be repeated. So Botox tends to normalise sweating not abolish it and the effects wear off over time. However, in one long term study 28% of patients were still happy 16 months after one treatment. In our experience our worst result occurred in one woman who felt sweating return after two months and our best result was in a male chef whose results lasted three years. One important bonus of treatment is that patients develop a trust in how Botox is normalising their sweaty area. Because they become less anxious that they will sweat, they sweat less.
Side Effects
There is a risk of local muscle weakness (Botox® paralyses muscles which is how it works in wrinkle reduction). No one has reported it happening in the armpit although it can occur in the hands making it hard for a while to open jars. Up to 5% of patients are said to get compensatory sweating elsewhere. It’s possible to get a bruise from the injections. Topical local anaesthetic reduces discomfort.
If you do decide that you want to consider Botox® then it’s best to come in and discuss your personal situation and treatment options in detail. Successful treatment means injecting the entire problem area so it helps if you can take note of exactly where your problem areas are. This information is used in addition to our medical tests to determine exactly where the sweating is coming from and therefore where to treat.
