What is hyperhidrosis?
Hyperhidrosis is a medical term for excessive sweating. This can affect many parts of the body but most commonly the armpits, palms of the hands and soles of the feet. It affects 3-5% of the population and can be extremely distressing having a major impact on their lives.
How do I know if I have hyperhidrosis?
Hyperhidrosis usually starts during puberty. Sufferers often have to change their clothing several times a day, and many choose to only wear black as this disguises the problem the best. It not only causes the patient distress but may also affect their daily interactions – for example many people associate sweaty palms with anxiety. Many hyperhidrosis suffers report these sorts of associations have caused them difficulty with both business and social interactions. In severe cases it can even cause problems with gripping pens and wearing open-toe shoes.
Is there anything I should try before I have Botox?
- There are dietary modifications that we would recommend you try – restricting caffeine intake (tea, coffee and caffeinated soft drinks), cutting out chocolate and spicy food may also help.
- Stronger anti-perspirants may also help. These are available over the counter, and the most commonly known one is Drysol. These are applied just before going to bed for 7 to 10 nights in a row, but can cause significant skin irritation
What is involved in Botox treatment for hyperhidrosis?
Prior to treatment you will have a thorough consultation to determine the severity of your symptoms. We will also take a medical history to make sure Botox is a safe and appropriate treatment for you.
When treating the armpits, some practitioners will perform a starch-iodine test to demonstrate the area where the sweating is worst. The area of worst sweating shown up is almost always the area where the hair growth is, and therefore we feel the test has minimal use. Nevertheless if we are unable to see the area of your hair growth we may perform the starch-iodine test to guide us.
When treating the palms of the hands or the soles of the feet we apply local anaesthetic cream for a full hour prior to treatment. This is because these areas are very sensitive and treatment can prove very painful. Even with the local anaesthetic cream the procedure in these areas will still be rather uncomfortable. Treatment of the armpits is normally tolerated well without local anaesthetic cream, although may still be a little uncomfortable.
Each side will normally be treated with around 30 individual injections made with a tiny needle. Afterwards I will apply arnica gel to minimise any bruising risk.
How should I prepare for my treatment?
We advise patients to shave their armpits 48 hours prior to treatment. Please avoid applying anti-perspirant on the day of treatment and come wearing a dark top (this is in case we do perform the starch-iodine test as it can stain your clothing).
Does it work instantly?
The Botox starts to work in most people between 3 and 5 days, with full effects by 2 weeks.
Are there any side-effects of hyperhidrosis treatment?
- The most common side-effect is tenderness at the injection sites, which resolves within the first 24-48 hours.
- Bruising is always a possibility, although we take every measure to avoid it – cooling the area initially, using extremely tiny needles, using a fresh needle in each area and applying Arnica gel prior to treatment.
- It is possible to get some weakness of the fine muscles in the area injected. This is probably most relevant when treating the palms of the hands.
- Rarely patients can develop more generalised side-effects such as tiredness, nausea, dry mouth (common in patients taking anti-histamines), difficulties swallowing and eye problems.
- Allergic reactions to Botox are possible but extremely rare.
What are the alternative treatment options?
There are surgical treatment options for hyperhidrosis. However these carry significant risks, and as such tend to be reserved for patients with symptoms also affecting the hands. For axillary (armpit) hyperhidrosis only a third of patients describe themselves as satisfied with surgical results, largely because of the side effects this procedure can have.
How long will the results last?
Botox for hyperhidrosis normally lasts around 4 months, although some patients describe symptom relief for much longer periods of time.