Tuesday, 24 June 2014

Hyperhidrosis - excessive sweating

Excessive sweating of the underarms or palms of the hands can be a terribly embarrassing condition.  Many patients will find that their social life suffers due to this.
Unfortunately many also done realise that this condition can be treated very successfully with Botox.
There are certainly also other treatment modalities available, although these can be more invasive.

Mechanism of action
Botox has an affinity for the receptors of the sweat gland.  Once it attaches to these receptors the nerve impulse that stimulates sweating is blocked. The hand and armpit this remain dry.

Majority of patients will choose to have the underarm treatment at the beginning of spring.
The palm treatment so common throughout the year as it is not so season dependent.
The effect of the treatment lasts about 6-9 months, but can vary in patients. 

I generally use topical anesthetic cream, but one can also use nerve blocks for the palm.  This stays on for about 45min.  This depends on the threshold of the patient.
For the underarm (axilla) I dont use anaesthesia as it is well tolerated without.
The treatment takes about 15min.  The effect will be noticed at about day 4 and will reach its maximum intensity at about 2 weeks.

Iodine test
This test can be performed to confirm the exact area of sweating.  I don't routinely undertake this.

This treatment changes peoples lives as they can resume normal social activities without feeling self-conscious or embarrassed.
Some have said that "its the best thing they have ever had done......."

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