Skin Club by DermaGenesis

Embarrassed to shake hands? Hyperhidrosis is a medical condition characterized by excessive sweating. While it is natural for the body to sweat, sweating beyond what is necessary can be irritating to the skin, embarrassing, and stressful. Botox has helped millions of people in treating excessive sweating.

Minute injections of Botulinum Toxin Type A, popularly known as Botox or BTA into the palm, underarm or sole have helped millions of people in treating excessive sweating, also known as hyperhidrosis.
People who suffer from hyperhidrosis may constantly worry about how much they are sweating. Occasionally, people with hyperhidrosis undergo emotional problems, including depression and decreased confidence. When hyperhidrosis affects the hands, feet, armpits, or face, it is called primary hyperhidrosis. When hyperhidrosis is caused by another medical condition or a medication, it is called secondary hyperhidrosis. Many medical conditions may cause secondary hyperhidrosis, including endocrine disorders. Additionally, hyperhidrosis can also be related to anxiety disorders.
There are two to four million sweat glands distributed over the body. The majority of these are “eccrine” sweat glands, which are found in large numbers on the soles of the feet, the palms, the forehead, and the cheeks, and in the armpits. Another type of sweat gland is called the “apocrine” gland. Apocrine glands are found in the armpits and genital region. They produce a thick fluid. When this fluid comes in contact with bacteria on the skin surface, it produces a characteristic potent smell. Both the eccrine and apocrine sweat glands are activated by nerves. These nerves respond to a variety of stimuli, including heat, hormones, emotions, exercise, etc. In the hyperhidrosis sufferer, sweat glands appear to overreact to stimuli and may be generally overactive, producing more sweat than is necessary. Hyperhidrosis appears to run in families, but little else is known about its exact causes.

Treatment of hyperhidrosis with Botox

This breakthrough procedure Botox or BTA has helped millions of people in treating excessive sweating, also known as hyperhidrosis. Research has shown that treating hyperhidrosis with Botox is safe and effective. Botox is a chemical neuro-peptide which blocks nerve impulses to muscles and sweat glands. When Botox is injected into a muscle, it blocks impulses from the nerve to the injected site. A cream is applied to numb the treatment area before the injections. In recent studies, when Botox was injected into underarm areas affected by hyperhidrosis, excessive sweating was relieved for an average of seven months. In 28% of those studied, the anhidrosis (or lack of sweating) lasted sixteen months. The injections require little time, and do not demand any restrictions in work or leisure activity (aside from refraining from intensive exercise or the use of a sauna on the day of the injections). U.S. Food and Drug Administration (FDA) approved the use of Botox for axillary hyperhidrosis on July 19th, 2004. It may take several injection sessions to achieve desired results and that during each injection session multiple injections are given in an attempt to cover the entire affected area. These injections can be uncomfortable especially in the palms and soles of the feet.

Effect of Botox / Dysport on Hyperhidrosis

Reduction of hyperhidrosis following Botox treatment lasts anytime between 5 to 6 months. In some individuals, for no known reason, the effects may last longer or shorter than the published information. Once the longevity of Botox wears out, the nerve impulse gradually re-establishes and sweating gradually reappears.

Safety, risks and side effects

Botox procedure is considered as one of the safest and well-regulated cosmetic procedures ever. It has been in practice for more than 20 years and leading Medical Societies, along with the US FDA regulate most of the Botox procedures. Regular injections of Botox into the facial muscles have been clinically proven to be harmless, produces longer-lasting results and effectively delays the onset of aging skin.
Side effects are minimal and typically relate to the local injection. Soreness or mild bruising, while uncommon, may occur around the injection site. Rarely, there might be temporary weakness of muscles near the injection sites, particularly small hand muscles and minor discomfort such as a stinging sensation. There is no limitation to the patient’s normal activity / lifestyle after the procedure and the patient can proceed with his / her routine chores as usual. Botox injection is contraindicated during pregnancy and lactation, while on antibiotics or at sites that has any infection.

Cost

Cost of Botox or Dysport treatment for hyperhidrosis ranges from RM 2000 - RM 2400 for the axilla (underarms) or the palms.

Other treatments for Hyperhidrosis

Topical agents
Topical agents for hyperhidrosis therapy include topical anticholinergics, boric acid, 2-5% tannic acid solutions, resorcinol, potassium permanganate, formaldehyde (which may cause sensitization), glutaraldehyde, and methenamine. All of these agents are limited by staining, contact sensitization, irritancy, or limited effectiveness. Because of the limitations of other agents, Drysol (20% aluminum chloride hexahydrate in absolute anhydrous ethyl alcohol) is more commonly used as the first-line topical agent. Drysol should be applied nightly on dry skin with or without occlusion until a positive result is obtained, after which the intervals between applications may be lengthened. To minimize irritation, the remainder of the medication should be washed off when the patient awakes, and the area may be neutralized with the topical application of baking soda.

Systemic agents
The systemic agents used to treat hyperhidrosis include anticholinergic medications. Anticholinergics such as propantheline bromide, glycopyrrolate, oxybutynin, and benztropine are effective because the preglandular neurotransmitter for sweat secretion is acetylcholine (although the sympathetic nervous system innervates the eccrine sweat glands). The use of anticholinergics may be unappealing because their adverse effect profile includes mydriasis, blurry vision, dry mouth and eyes, difficulty with micturition, and constipation.

Antiperspirants
For some people who sweat excessively antiperspirants might help. While typically marketed for use on the underarms, antiperspirant products can also be used to help control sweating on the hands and feet. Antiperspirants work by blocking or plugging your sweat ducts, thereby reducing the amount of perspiration that reaches your skin. Antiperspirants are considered by many to be the “first line” of treatment for armpit hyperhidrosis. The most widely used ingredients in antiperspirants are metallic salts. Preparations containing aluminum chloride hexahydrate are among the most effective. Aluminum chloride hexahydrate concentrations of 10% to 15% are recommended for excessive sweating of the armpits. For the palms or soles, higher concentrations are required - usually around 30%. Some antiperspirants also contain deodorants. Deodorants, on their own, cannot prevent sweating, but they can reduce or eliminate odor by turning your skin acidic, which makes it less attractive to bacteria.

Iontophoresis
During iontophoresis, the hands and feet (if both areas are affected by excessive sweating) are submerged in lukewarm water. Electricity is then conducted through the water. The amount of electricity sent through the water is gradually increased until the person being treated feels a tingling sensation for about 10 to 20 minutes. Iontophoresis treatment typically involves three to four sessions per week. Sweating symptoms usually improve after five to ten sessions. To maintain the sweat relief, one or two sessions of “maintenance” iontophoresis per week are often required. Iontophoresis may be used to treat excessive sweating of the armpits, but it is more effective and tolerable when used for sweating of the hands and feet.

ETS (Endoscopic Thoracic Sympathectomy) surgery
ETS surgery interrupts the transmission of nerve signals from the spinal column to sweat glands, thus preventing the sweat glands from being “turned on.” One to three small incisions are made in the armpit and an endoscope (a small telescopic camera) is inserted. The surgeon will follow the passage of the endoscope to the nerve which transmits signals to the sweat glands. The surgeon cuts the nerve signals, or pathways depending upon whether the hyperhidrosis to be treated involves just the hands or both the hands and the armpits. An experienced surgeon must do it. This procedure is used to prevent excessive sweating when all other non-invasive treatments have failed. It is used only as a last resort to treat hyperhidrosis of the palms, face or other areas.