What is Hyperhidrosis?
Hyperhidrosis or excessive sweating is abnormal excessive sweating that is not necessarily related to heat or exercise. The body produces more sweat than is required to regulate its body temperature. Individuals affected by hyperhidrosis may find that their sweat is constantly soaking through clothing or that they have to wipe their palms dry. It is estimated that 1.3 million Americans have been diagnosed with severe hyperhidrosis. Severe sweating can interfere with jobs, social life, personal relationships and confidence level.
How do I know if I have Hyperhidrosis?
Primary hyperhidrosis is most often times diagnosed as being idiopathic, that means that there is no specific cause for the excessive sweating. Secondary hyperhydrosis usually has a cause that can be identified such as emotional and psychological triggers, heat, spicy foods, endocrine (hormonal) disorders, physical activity, etc.
Patients with hyperhidrosis meet at a minimum 2 of the following criteria:
- Excessive sweating that last for 6 or more months, with a frequency of more than once a week
- Impairment of daily activities
- Bilateral (both sides) symmetric sweating
- Positive family history of members with excessive sweating
- Onset before the age of 25
- Cessation of focal sweating while asleep
- The most common areas of focal hyperhidrosis are the axilla (armpit), palms, and soles.
How severe is your excessive sweating (Hyperhidrosis)?
Hyperhidrosis Disease Severity Scale
Adapted from the Hyperhidrosis Disease Severity Scale study
|1||My underarm sweating is never noticeable and never interferes with my daily activities.|
|2||My underarm sweating is tolerable but sometimes interferes with my daily activities.|
|3||My underarm sweating is barely tolerable and frequently interferes with my daily activities.|
|4||My underarm sweating is intolerable and always interferes with my daily activities.|
Sweating is very common amongst all humans, but in some cases it can be very severe. There are many different treatments from deodorants, to Botox and surgeries that could change your life. In a much more mild situation, the sweating is almost unnoticeable and will not interfere with your daily life. Patients with more sweat might notice they have to change their clothes throughout the day and doing simple, daily activities can become difficult.
What are treatment options for Hyperhidrosis?
The most common over the counter treatment for excessive sweating is deodorant and antiperspirant use. However, antiperspirants and deodorants are usually only applied to the underarms and cannot help with plantar sweating or palmar sweating. Some patients find that even the strongest antiperspirants containing aluminum chloride do not do much to decrease the amount of sweat produced. Even if antiperspirants can help they are usually short-acting and would require multiple applications throughout the day.
Your physician can suggest both surgical as well as non-surgical treatment options to help relieve hyperhidrosis. One of the most common yet under marketed uses for Botox® is for excessive sweating. Most patients associate Botox® as being an anti-aging product used to decrease the appearance of wrinkles on the face. What most patients don’t know is that Botox® was FDA approved in 2004 for the treatment of excessive sweating in the axilla (underarm). Botox weakens the nerves around the sweat glands to help decrease sweat production. Botox® injections to the sweat glands can afford patients up to 4-6 months of relief from sweating. Typically 50-100 units of Botox® is injected per side of the treatment area (underarm, palms The Botox® treatments are usually repeated every 2-3 times a year.
The most invasive means for treating hyperhydrosis is to undergo a sweat gland reduction procedure. In a glandular reduction procedure the patient’s sweat glands are permanently and surgically shaven off. Although not 100 percent of the sweat glands are removed, the amount surgically excised is significant enough to produce a noticeable decrease is sweat production. Sweat gland excision is typically performed in office under local anesthesia.
How does Botox for Hyperhidrois work?
Botox works by blocking the nerves responsible for activating your sweat glands. Normally, your nervous system activates your sweat glands when your body’s temperature rises. This is how your body automatically cools itself. In people with hyperhidrosis, the nerves that signal the sweat glands are overactive.
Botox® injections in the vicinity of the nerves responsible for sweating helps decrease the amount of signal these nerves are sending to the sweat glands. The blockage of these nerve impulses essentially helps to reduce sweat production.
How to prepare for your treatment
The Botox treatment areas will be wiped with a cleanser and alcohol. 20 minutes prior to your treatment a topical numbing medication will be applied to ease the pain from the injections. For underarm injections please wear loose and comfortable clothing to prevent rubbing and chafing in the treatment area.
After your appointment
- Do not apply pressure to/or massage the treatment area.
- Pinpoint bleeding may occur and will resolve quickly.
- Mild temporary bruising and or sensitivity around the injection site may develop. This will resolve within the first week after treatment.
- Any immediate redness or swelling will subside within an hour.
Does it hurt to treat Hyperhidrois with Botox®?
The pain associated with armpit or palmar Botox® can be uncomfortable. At The Naderi Center we offer patients complimentary topical numbing crème that is applied 20 minutes prior to the procedure. Some patients describe the sensation of the injection as similar to plucking hair.
How long do Botox® injections for sweating last?
Every patient breaks down Botox® differently so the duration of the results will vary. Typically, patients experience dry armpits for around 3 to 6 months after receiving Botox® injections. However, exercise and stress can accelerate the body’s metabolic response to Botox®, causing the result to fade quicker.
How long does Botox treatment to the underarms or palms takes?
Botox® injections to the armpits or palms usually takes our physicians about ten minutes to perform. Minor bruising for a few days can be expected.
What are the Disadvantages of Botox® Injections for sweating?
The primary disadvantage to treating hyperhidrosis with Botox® is the impermanence. Typically, the treatment lasts at most six months. Multiple treatments are required. Patients who have had more than four treatments are less tolerant of symptoms once they become accustomed to sweating less (anhydrosis).
What are the Contradictions of using Botox® to treat Hyperhidroiss?
Botox injections to the sweat glands can be contraindicated in patients that have an underlying medical condition that is causing hyperhidrosis, are taking blood thinners, have severe blood clotting disorders or have had surgical debulking of their sweat glands.
What is the typical patient satisfaction rate form treating Hyperhidrosis with Botox®?
Patients who have undergone Botox® injections claim a significant decrease in excess sweat production and are happier with their overall quality of life. Patients also generally feel that Botox® injections work better than other nonsurgical options such as antiperspirants and oral medications to reduce sweating.
Is Botox® for Underarm Injections a new treatment modality?
No. The FDA approved Botox® to treat severe underarm sweating in July of 2004.
How do I know if I am a Candidate for Treatment of Hyperhidrois with Botox®?
You may be a candidate for Botox® if your sweating fails to improve with prescription antiperspirants. Botox has been FDA-approved for people who sweat excessively from their armpits and is commonly used off-label for sweating of the palms. It is best to consult a medical professional to see if you can benefit from Botox® for excessive sweating.
What is the Cost of Botox for Hyperhydrosis?
Botox® treatments for the armpits or palms is $12/unit. Most patients require 100 units.