Hyperhidrosis Patient Information

What is Hyperhidrosis?

In some people, the body’s mechanism for cooling itself down is over active- so over active that they may sweat four or five times more than is necessary, or normal. When sweating is this extreme it can be embarrassing, uncomfortable, anxiety inducing and life inhibiting. It can disrupt all aspects of a person’s life, from career choices and recreational activities to relationships, emotional wellbeing and self-image. This kind of excessive sweating is a medical condition called hyperhidrosis.

‘Hyperhidrosis affects approximately 3% of the population, but due to lack of awareness, more than half of sufferers are never diagnosed or treated for their symptoms.’

What Causes Hyperhidrosis?

Excessive sweating can be a symptom of certain medical conditions or a side effect of some medications. You should not have treatment for your hyperhidrosis without first consulting your GP to exclude any underlying medical condition which requires treatment.

Your GP will check for potential causes of secondary hyperhidrosis to avoid symptomatic treatment of hyperhidrosis without the diagnosis and/or treatment of the underlying disease.

The cause of primary hyperhidrosis is not known.

What Treatments are Available?

There are a range of treatments available for hyperhidrosis, many are available on prescription. They includeAntiperspirants, Creams and Lotions, IontophoresisMedications, Laser, Surgery, MiraDry, Injections of Botox.

There is a wealth of information available on the internet, not all of it responsible, factual or impartial. We recommend you visit the website of The International Hyperhidrosis Society; www.SweatHelp.org for useful and reliable information.

Botox® has been licensed to treat underarm sweating since 2004. Research has shown that treating excessive sweating of the armpits, hands, feet, and face with Botox®(Botulinum Toxin A) is safe and effective. In one clinical study involving 322 patients with severe underarm sweating, 81% of the patients receiving botulinum toxin injections achieved a greater than 50% reduction in sweating. And, 50% of the patients had their excessive sweating relieved for at least 201 days (nearly 7 months).

How Does Botox® Work?

Botox® is a natural, purified protein with the ability to temporarily block the secretion of the chemical that is responsible for "turning on" the body's sweat glands. By blocking, or interrupting, this chemical messenger, botulinum toxin "turns off" sweating at the area where it has been injected. While sweating is an essential body function for temperature-control, the underarms house less than 2% of the body’s sweat glands. The treatment of these sweat glands has no effect on body temperature regulation and compensatory sweating (sweating on other body parts), has not shown itself to be a concern.

Botox® is injected into the skin to treat the symptoms of severe underarm sweating (severe primary axillary hyperhidrosis) when medicines used on the skin (topical) do not work well enough.

Am I Suitable for Treatment with Botox®?

If you have seen your GP, your diagnosis is confirmed and you have tried and failed to get along with alternative topical treatments, then it is likely, subject to your medical history, that Botox® would be an appropriate treatment for you.

The nurse will take a full medical history to confirm you have no medical contraindications to Botox ®.

You may not be suitable for Botox® treatment if you have any of the following:

  • A neuromuscular transmission disorder such as Myasthenia gravis or Eaton Lambert Syndrome.
  • Aminoglycoside antibiotics within the last 3 days (Gentamycin, Clindamycin, Tobramycin)
  • If you are pregnant (or might be) or are breast feeding.
  • If you have a skin infection at the site for treatment.
  • If you have had previous adverse, sensitivity reactions to any botulinum toxin.

What Does the Treatment Involve?

The nurse will first identify where the sweat glands are most active. This is done by applying iodine solution to the treatment area, then dusting with starch powder. The area turns blue/black where there is sweat. The area is marked with a surgical pen, then cleaned prior to injection.

Injections are spaced approximately 2cm apart to treat the area. The needles are tiny, the injections are not deep and most patients report tolerable discomfort rather than pain. Be Prepared

  • Please shave underarms and avoid using over the counter antiperspirants or deodorants 24 hours before.
  • It is advisable to avoid aspirin and non-steroidal medication, vitamin E, gingko biloba and St. John’s Wort for at least 24 hours prior to treatment as these may increase the risk of bleeding and bruising.
  • If you have been prescribed aspirin for a medical reason, it is best to continue this. If you have a bleeding disorder, or are taking Warfarin, discuss this with the nurse prior to receiving botulinum treatment.
  • Wear a dark, loose top, preferably an old one to the appointment. You may bleed a little and iodine may stain clothing.

After Treatment

The treatment area may feel sore and or tender for the first 24 hours. Some patients describe an achiness, tiredness or heaviness of the arms which usually resolves within a few days from occurring.

Results are gradual and may be judged at 2-3 weeks. You are invited for a review appointment to record the effectiveness of treatment and modify your treatment plan if necessary. Sometimes an additional treatment is required to achieve optimal results.

Keep the area clean. You may apply antiperspirants as soon as the skin has recovered from the injections- usually within 4-12 hours.

Avoid vigorous exercise or extreme heat for 48 hours after treatment.

Should you experience any unpleasant side effects that you are not expecting, or suffer symptoms that concern you, please do not hesitate to contact the clinic and an appointment will be made for you to be seen.

The treatment may not completely stop any sweating, but we expect the sweating to be significantly reduced. Treatment results are expected to last approximately 6 months. For some individuals this may be shorter, or even longer.

Once the Botox® wears off, your condition will return to its previous state, there is no permanent effect on your condition, either for the better, or for the worse.

If you have any further questions, before, during or after the treatment, do not hesitate to ask your practitioner.