Excessive Sweating

DON’T SWEAT IT WITH BOTOX Imagine sweating so excessively from your hands that you avoid shaking hands with people. Imagine sweating so profusely from your underarms that you need to take several shirts with you because you have to change several times a day. Imagine perspiring so much from your feet that your shoes and socks look as if you just came in from a downpour.

Excessive sweating is a medical condition known as hyperhidrosis. This can be localized to specific areas of the body, most commonly the armpits (axillary hyperhidrosis), palms (palmar hyperhidrosis), or soles of the feet (plantar hyperhidrosis). People can also sweat profusely from the face, according to the International Hyperhidrosis Society. When the condition is severe it can lead to significant effects on the quality of life, causing stress and impairment in social or work situations. It can be especially devastating to a person’s ability to maintain relationships with others. Botox® has been shown in several medical studies to be a very effective treatment for people with localized sweating (hyperhidrosis) of the axilla, palms, and soles. Botox® is now FDA approved for treatment of hyperhidrosis.

Medical Articles

Efficacy and Safety of Botulinum Toxin Type A in the Treatment of Palmar Hyperhidrosis: A Double-Blind, Randomized, Placebo-Controlled Study, Lowe, N. J; Dermatol Surg 2002;28:822-827.

Botulinum Toxin Type A Is a Safe and Effective Treatment for Axillary Hyperhidrosis Over 16 Months, Naumann, M.; Arch Dermatol 2003;139:731-6.

Effect of Botulinum Toxin Type A on Quality of Life Measures in Patients with Excessive Axillary Sweating: A Randomized Controlled Trial; Naumann, M.; British Journal of Dermatology 2002;147:1218-1226.

Effective Treatment of Frontal Hyperhidrosis with Botulinum Toxin A; Kinkelin, I.; British Journal of Dermatology 2000;143;824-7.

Frequently Asked Questions

1. How does Botox work?	Botox® works by temporarily blocking the release of the neurotransmitter (acetylcholine) from the nerve endings that cause the glands to produce sweat.
2. How effective is the treatment?	Sweating is decreased by 70 – 90% within one week and there may be simultaneous disappearance of odor as well. With one treatment most people obtain the benefit of dryness for 6 to 10 months.
3.What are the medical options for the treatment of hyperhidrosis?	The first is a prescription antiperspirant, Aluminum Chloride (Drysol), used in topical sticks, creams, lotions, and solutions. These prevent sweating by clogging the sweat ducts in the skin, however they can be irritating with continued use and are usually ineffective. A non-prescription topical antiperspirant new to the market is Maxim. Oral medications often provide relief but can cause dry mouth and blurry vision. Tranquilizers may minimize one’s anxiety but do little to diminish actual sweating.
4. What is tap water iontophoresis?	Tap water iontophoresis is a battery-powered electrical device that uses an electric current held against the skin for several hours. This may be mildly effective but is time-consuming and may need to be repeated on a daily or weekly basis.
5.  Are there any surgical alternatives?	There are surgical alternatives such as endoscopic thoracic sympathectomy (ETS), which requires neurosurgeons to use a fiber-optic camera inserted into the chest under general anesthesia to cut specific nerves. Although this approach is approximately 85% successful for the hands, feet, and underarms, there are potential risks and complications associated with the procedure. Other alternatives have been to remove the skin containing the sweat glands under the arm, which will leave visible scars and numbness or scraping under the skin with liposuction cannulas, which has variable results.
6. Who can treat hyperhidrosis?	Only a medical professional can diagnose severe primary hyperhidrosis. Be prepared to tell Dr. Biskin about your medical and family history. You will be asked to fill out a questionnaire regarding the extent to which severe sweating affects your daily activities. This is known as the Hyperhidrosis Disease Severity Scale (HDSS). Once a diagnosis has been made Dr. Biskin will discuss the appropriate treatment options with you.