What is Hyperhidrosis?
Hyperhidrosis means excessive sweating. Sweating is one of the most important ways in which the body loses heat; however, people with Hyperhidrosis produce sweat in amounts far greater than needed to control their temperature.
There are two main types of Hyperhidrosis:
1) Focal Hyperhidrosis is the more common type involving excessive sweating on the feet, hands and, in about 30-40% of cases, the armpits. The face may also be affected, but less often, even less common is gustatory Hyperhidrosis, when sweating on the face is triggered by hot or spicy food.
2) Generalised Hyperhidrosis affects the whole body. It is much less common and is usually caused by another illness such as infection, diabetes or when the thyroid gland is overactive. The excessive sweating usually stops when the illness is treated.
What is Botox and how does it work?
Botox is a treatment given by injection into the skin. It is indicated for the treatment of auxiliary Hyperhidrosis and it has also been used for many years to treat muscle spasm affecting the eyes, face and neck. Botox is also used to relieve muscle spasm in children with cerebral palsy.
Botox is a very pure preparation of a protein, botulinum toxin type A, obtained from the bacterium Clostridium botulinum grown under modern methods of cultivation. When small doses are injected into the skin, Botox blocks the actions of the nerves that supply the eccrine glands; this prevents the glands from producing sweat. Botox blocks the nerve endings but over 6-12 weeks new nerve endings grow to replace them. This means that the effects of the treatment last for several months but eventually they wear off.
What happens during a course of treatment with Botox?
Using a very fine needle your practitioner will inject a small amount (0.1-0.2ml) of a solution of Botox into 10 to 15 places about 1cm apart and spread evenly in each armpit. A dye is used to show the areas where sweating is greatest and where the injections should be placed. A course of treatment takes about 30 minutes
Does it hurt?
The needles used are very fine so most people experience only mild discomfort. It is uncommon for pain relief to be required.
How quickly does it work and how long will the effects last?
You should notice some changes for the better within a week of your treatment.
Different people have different responses to treatment. In a clinical trial, sweat production was reduced by 83% one week after treatment. Furthermore, sweating was reduced by at least half in 95% of patients. Your next treatment can be given when the effects of the first course wear off, this usually happens after 4-7 months.
What happens if I decide to stop treatment?
The effects of Botox wear off over a period of several months. If you decide not to have any further treatment there will be no lasting change in the areas treated. Sweating will gradually return to the level it was before you started treatment.
Are there any side effects?
Every treatment has side effects in at least some patients. In clinical trials of the treatment of auxiliary Hyperhidrosis with botox, 11% of patients reported a side effect. About 4.5% of patients experienced an increase in sweating in another part of the body.
Since the injection is made only into the skin, the effects of Botox will be limited to the nerves supplying the sweat glands. Occasionally, a very small amount of Botox may spread out from the injection site and affect a nearby nerve that supplies a muscle. In clinical trials, about 0.7% of patients experienced mild weakness of the arms; this did not last and got better without any treatment.
Because Botox is a protein, there is a small chance that ‘flu-like’ symptoms (tiredness, mild fever, muscle aches) may occur, these will disappear within a few days. You may also feel a little discomfort at the injection sites.
