Hyperhidrosis (Arm pit sweating)

Hyperhidrosis is a medical condition characterized by excessive sweating. In some cases, excess sweating can occur despite the lack of a trigger and can even occur at odd times, such as when it is cold. Hyperhidrosis can develop as a primary condition or as a result of other medical conditions. There are two main variations of hyperhidrosis including: 

  • Primary focal hyperhidrosis: this type usually begins during childhood and has a genetic component. It is characterized by sweating that occurs on the feet, hands, face, head, and underarms. 
  • Secondary generalized hyperhidrosis: this type usually begins during adulthood and is caused by another medical condition. It is characterized by sweating that occurs all over the body, in one specific area, or while sleeping. 

Botox is a neurotoxin produced by Clostridium botulinum bacteria that is commonly used to treat symptoms associated with hyperhidrosis. When it is injected into sweat glands, the neurotoxin interrupts the signal that causes the nerves to stimulate sweat glands. As a result, the body will be unable to sweat from the injected sweat gland. However, Botox is only effective where it is injected. 

Did You Know?

Botox is most effective in treating underarm sweating, however it can be used to other areas of the body as well. Studies show that Botox has been used to successfully treat 80-90% of sweaty palm cases. It has also been shown to reduce forehead sweating by 75%. 

Frequently Asked Questions: 

Am I a candidate for treating hyperhidrosis with Botox?

You may be a candidate for treating hyperhidrosis with Botox if you are experiencing excessive sweating in one or more areas of your body. However, Botox may not be an ideal treatment for everyone, and people with nerve or muscle conditions, breathing-related problems, or who are on certain medications may be at an increased risk for side effects. Therefore, you will need to schedule a consultation at Premier Neurology to determine if you are an ideal candidate. 

What can I expect when having hyperhidrosis treated with Botox?

All Botox injections are performed in our office with a fine needle. When having hyperhidrosis treated with Botox, you can expect to receive injections approximately once every three months. The specific location of the injection will depend on the location of your symptoms and in some cases, more than one injection may be used. Although Botox has only been approve to treat underarm sweating, it can be used “off label” to treat sweating in other areas of the body. 

The effects of Botox treatment can last anywhere for 4-14 months, however this can vary depending upon the treatment location and the individual. After your Botox injection, you will need to schedule a follow up appointment 2 weeks out. This follow up appointment will allow your neurologist to evaluate your progress to determine the best course of action moving forward. 

What can I expect after having a Botox injection?

After your Botox injection, you will be able to return to your usual activities. It usually takes about 2-7 days for the Botox to have an effect, however this can vary from patient to patient. In some cases, it can take up to two weeks to completely eliminate sweating. 

Some patients may also experience pain or soreness at the injection site. This can be resolved with over the counter medications and applying ice packs to the area. In rare cases, you may also experience side effects such as temporary muscle weakness or infection of the injection site. 

Treatment Options:

For many patients, treatment will begin with topical antiperspirants starting with over-the-counter products, “clinical strength” over-the-counter products (active ingredient often zirconium salts), and then prescription products (active ingredient often aluminum chloride hexahydrate).

If a patient does not adequately respond to topical antiperspirant therapy, or if the side effects of such therapy are intolerable, onabotulinumtoxinA (BOTOX) injections are one of the next lines of treatment. The U.S. Food & Drug Administration (FDA) has approved onabotulinumtoxinA for the treatment of primary axillary hyperhidrosis in patients unable to obtain relief with antiperspirants.

Botox injections offer a minimally invasive treatment option and should be repeated as necessary to control symptoms. Botox is an excellent treatment for patients who complain of excessive and profuse sweating of the armpits, hands or feet.

Dr Kashouty and Dr Yono are highly trained and skilled in performing Botox treatments.

Resources:

https://www.sweathelp.org/treatments-hcp/clinical-guidelines/primary-focal-hyperhidrosis/primary-focal-axillary.html

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