Sweating is a natural function by which the body regulates its temperature. People with hyperhidrosis sweat more than is required, frequently resulting in unpleasant body odour. Excessive sweating, mostly from the armpits, hands or feet, results in a huge build-up of moisture on the surface of the skin, to the point where it is unable to fully evaporate. The majority of people suffer from moderate hyperhidrosis at some point in their life. Men and women, all races and every age group are affected.
Excessive sweating can occur at any time, in cold or hot conditions, whether the person is calm or under stress. It is a distressing problem, and this may in itself worsen the condition. It interferes with normal daily work and social routines due to the embarrassment caused.
What triggers and/or affects hyperhidrosis?
Triggers include:
1. Exercise;
2. Extreme temperatures;
3. Drinking alcohol, coffee or tea;
4. Smoking;
5. Hot or spicy food;
6. Stress;
7. Anxiety or strong emotions.
What problems does hyperhidrosis cause?
1. Lack of confidence;
2. The need to avoid certain foods and drinks;
3. Embarassment at work or in social situations. Most sufferers find this distressing, worsening the condition;
4. The need to wash or shower more frequently;
5. The need to change clothes several times a day, and to wear colours that do not show sweat;
6. Discolouration of clothes.
The treatment process
Prior to a decision to proceed with any treatment Dr Drucker will provide a detailed consultation during which she will give you an account of the procedure, will record your medical history, and will help you to decide whether the standard treatment process (repeated small injections of Botulinum toxin A) is appropriate for you.
Though not really necessary, a local anaesthetic can be applied to the treatment area (eg usually the armpits, feet or hands) for your comfort, if desired.
An iodine-and-starch test is used to locate the area where the sweating is greatest. Using a very fine needle, a minute amount of Botulinum toxin A ('Botox') solution is then injected into the skin at 15 or more sites, spaced 1cm apart. The treatment is very mildly uncomfortable due to the tiny pin-pricks, and takes about 35-45 minutes. In general, no pain relief is required post-treatment.
The speed and longevity of the results
Improvements should be noticed 7-14 days after treatment. Nerve endings in the treated area are completely blocked for 6-12 weeks, before new ones grow to replace them. The next treatment should be planned before the effects wear off, which usually happens 9-12 months after the first treatment.
Possible side-effects
A small number of patients develop increased sweating in other parts of the body.
Although injected superficially into the skin, it is possible that a small amount spreads into the nerves supplying the muscles underneath. Clinical trials have reported that 0.07% of patients develop a slight weakness in the arm when treated in the armpit. No intervention is needed.
There may be a slight discomfort and a small amount of bruising at the injection site.