Hyperhidrosis (Excessive Sweating)

Hyperhidrosis (Excessive sweating)

Hyperhidrosis (Excessive Sweating) Treatment at Cosmetech.  Helping Hyperhidrosis sufferers get the answers they need.

What is Botulinum toxin type A?

Botulinum toxin type A is a treatment given by injection into the skin. When not used for cosmetic reasons it is often referred to as ‘Therapeutic’.

It is licensed in the UK for treating localised hyperhidrosis of the armpits (axillae). This drug has been used for many years to treat muscle spasms affecting the face, eyes and neck. It is used to treat foot problems in children with cerebral palsy. It is also widely used for cosmetic purposes.

Therapeutic botulinum toxin is a preparation of protein. When small doses are injected into the skin, it blocks the nerves that supply the eccrine glands. This prevents the glands from producing sweat.

The treatment is not a cure for hyperhidrosis.  It only provides temporary relief. It needs to be repeated every three to six months for maximum effect.

Therapeutic botulinum toxin injections are not licensed in the UK for palmar (hands) or plantar (feet) hyperhidrosis.  It can however be performed at some private hospitals. The skin in these areas is sensitive, and the treatment can therefore be painful unless an anaesthetic is applied. It would need repeating on average every 4 months, and so a general anaesthetic each time is not generally recommended. A local anaesthetic can be given.


When is it used?

It is usually considered when topical treatments such as antiperspirants, iontophoresis and medications have been unsuccessful. Therapeutic botulinum toxin is only effective in treating small areas. It is therefore not a viable option for treating generalised hyperhidrosis.


How does it work?

Sweat glands are actually in the skin, not underneath it. When you sweat, a chemical messenger is sent to the sympathetic nerves that meet your sweat glands, turning the sweat ‘on’.

When therapeutic botulinum toxin is injected, the toxin blocks the chemical messenger sent to your sympathetic nerves and so it does not reach the sweat glands. Without the chemical message, the glands cannot turn on the sweating. Therapeutic botulinum toxin permanently blocks the nerve endings and so sweat cannot be produced. Within 6-12 weeks, your body starts to produce new nerve endings. These new endings can receive the message to turn those particular sweat glands on, so mild sweating returns. Within 4-12 months, all of the new nerve endings have been produced. This means the full chemical message can be received, turning all of the sweat glands on again. Sweating returns to normal and the treatment has finished.


The procedure

The physician will have a consultation with you before the treatment. This helps to determine where sweating occurs at its worst and to ensure that you have no health problems that Therapeutic botulinum toxin may interfere with or worsen. You will then be told the possible side effects of the procedure to forewarn you of any unwanted symptoms. It is important to note that you will be awake during the procedure and this is perfectly normal and is common practice.

Firstly, the site of injection will be cleaned to avoid infection. Secondly, any anaesthetic that is required will be administered, but this is generally not necessary in the axillae. Thirdly, you will be injected with a very fine needle which will introduce the botulinum toxin.

Therapeutic botulinum toxin is used most frequently with sweating under the arms (axillae), with each armpit administered around fifteen injections which are completed relatively quickly.Treatment for the hands and feet is a bit different in that injections can be rather painful and the treatment will take longer.

Most Therapeutic botulinum toxin procedures are over within 15-45 minutes, depending on the site of injection.


Aftercare and possible side effects

It can take up to a week for the Therapeutic botulinum toxin to start working properly.  It is important not to expect a miraculous disappearance right away. Your physician may ask you to avoid massaging the area or putting pressure on the injection site for a few days, and to avoid strenuous activity. The site may be a little painful and small bruises can form, but these symptoms go away within a day or two.

Many patients experience muscle weakness when they have had Therapeutic botulinum toxin injections, but this does wear off eventually. Some patients have experienced an increase in sweating in another part of the body.

The Therapeutic botulinum toxin treatment can often cause tiredness and blurred vision, flu-like symptoms and possibly arm and neck ache for those who have injections in their armpits. These are all temporary symptoms and should disappear in a few days, and not everyone experiences them. There are no severely uncomfortable sensations or effects which should affect your daily life and there are rarely any complications.

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Maypole Clinic