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Excessive
Sweating (Hyperhidrosis)
What is Hyperhidrosis?
Hyperhidrosis means excessive sweating. Sweating is one of the most
important ways in which the body loses heat, however, people with
hyperhidrosis produce sweat in amounts far greater than needed to
control their temperature.
There are two main types of hyperhidrosis:
Focal hyperhidrosis is the more common type involving excessive
sweating on the feet, hands and in about 30 – 40% of cases,
the armpits. Botox®® is recommended for the treatment of
focal hyperhidrosis affecting the armpits (axillary hyperhidrosis)
when other treatments have not worked.
Generalised hyperhidrosis affects the whole body. It is much less
common and is usually caused by another illness such as an infection,
diabetes or when the thyroid gland is overactive. The excessive
sweating usually stops when the illness is treated.
How common is hyperhidrosis?
It has been estimated that up to 1% of the population has some form
of hyperhidrosis. It usually starts during the teens and twenties.
What are the causes of hyperhidrosis?
It’s not known why some people are affected and others are
not. About 1/3 to ½ of people with hyperhidrosis have a relative
with a similar problem, suggesting that there maybe a genetic cause.
Hyperhidrosis is caused by over activity of one type of sweat gland,
the eccrine gland. These glands are found virtually all over the
body surface but they are concentrated on the palms of the hands,
the soles of the feet and in the armpits.
Many things can trigger normal sweating and this is also true for
hyperhidrosis – it’s just the amount of sweating that
varies.
Examples of triggers include:
· exercise, heat or cold,
· alcohol, coffee or tea,
· smoking, hot
or spicy food,
· stress, anxiety or strong emotions,
· certain times of the day
People with hyperhidrosis can produce a large volume of sweat. This
means that the hands, feet, chest or armpits (depending on which
part of the body is affected) may be constantly damp. This may make
normal everyday activities more difficult to carry out and it can
cause embarrassment at work or socially. However, it is not true
that hyperhidrosis cause’s body odour the smell that some
people think is due to sweating is in fact caused by bacteria if
sweat remains there for a long time.
What is Botox® and how does it work?
Botox® is a treatment given by injection into the skin. It is
recommended for the treatment of auxiliary hyperhidrosis and it
has been used for many years to treat muscle spasm affecting the
eyes, face and neck. Botox®® is also used to relieve muscle
spasm in children with cerebral palsy. Botox® is a very pure
preparation of a protein, botulinum toxin type A. When small doses
are injected into the skin, Botox® blocks the actions of the
nerves that supply the eccrine glands, this prevents the glands
from producing sweat. Botox® blocks the nerve endings but
over about 6-12 weeks new nerve endings grow to replace them.
This means that the effects of treatment last for several months
but eventually they will wear off.
What happens during treatment?
Using a very fine needle, your doctor will inject a small amount
of a solution of Botox® into 10 to 15 places about 1cm apart
and spread evenly in each armpit. Sometimes a dye is used to show
up the areas where sweating is greatest and where the injections
should be placed. A course of treatment takes about 30 minutes.
How quickly does it work and how long will the effects
last?
You should notice some change for the better within a week of
your treatment.
Different people have different responses to treatment. In a clinical
trial, sweat production was reduced by 83% one week after treatment.
Furthermore, sweating was reduced by at least half in 95% of patients.
Your next treatment can be given when the effects of the first
course wear off, this usually happens after 4 to 7 months.
Your doctor will advise you about when to return for further treatment.
Is the procedure painful?
The Botox® is administered using a very fine needle, the injections
are only administered at a depth of 2mm causing very little discomfort.
In extremely rare cases, patients can develop an allergy to the
treatment or some patients may not respond to the treatment.
How much does the treatment cost?
The cost of the treatment is £500 for both armpits.
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