Excessive Sweating

Excessive Sweating – what changes can I make to my lifestyle to help relieve my symptoms?

Wearing cool, light clothing helps your body to regulate its temperature and avoid overheating.

Loose cotton clothing, especially cotton shirts and thin socks for those with axillae and plantar hyperhidrosis, helps immensely with excessive sweating, as it is a more breathable fabric.

Avoid man-made products, and wear leather shoes.

Use aluminium chloride antiperspirants and emollient washes and moisturisers  rather than soap based cleansers.

Spicy food, alcohol and hot or caffeinated drinks are notorious for inducing excessive sweating episodes.

A more basic adaptation might be to simply invest in a fan for the home or office in the summer months.

One helpful tip is to monitor your sweating and note what causes it, and adapt your lifestyle accordingly. Don’t put yourself in situations where your excessive sweating/hyperhidrosis may be made worse.  Causes vary from person to person, but typical triggers include rushing and stressful situations.

Excessive Sweating – How does Botox® 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’ and sometimes this is excessive.

The process is outlined as follows:

  1. Sweat glands in your skin require turning on
  2. Botox® botulinum toxin is injected into your skin
  3. Your nervous system still sends a chemical message to the sympathetic nerves, but they cannot receive it – Botox® botulinum toxin has temporarily blocked the nerve endings.  The message cannot go any further
  4. The message doesn’t arrive.  Your nerve endings are temporarily blocked and so the sweat glands do not turn on
  5. You enjoy a reduction in sweating, but within 6-12 weeks your body starts to grow some new nerve endings
  6. Slowly, the path of the chemical messenger becomes clearer.  The new nerve endings can receive the message, enabling it to turn on the sweat glands it meets.  At the same time the effect of the toxin is reducing, so mild sweating returns
  7. Between 4-12 months, all the new nerve endings have retracted and the effect of treatment has completely disappeared.  The nerves receive the message again and sweating returns to your normal level
  8. The effect of treatment has finished.
Excessive Sweating – Treatment onset and duration

Onset starts from about three days from treatment for excessive sweating, as patients notice they can use a lighter anti-perspirant or not need an anti-perspirant at all.

The degree of dryness a patient achieves may vary and a true excessive sweating or hyperhidrosis sufferer may be pleased with a reduction in perspiration to a normal, manageable level.

Someone whose perspiration is not so severe may achieve total dryness.

In one clinical study, 81% of the patients receiving Botulinum toxin injections achieved a greater than 50% reduction in excessive sweating.

The benefit of treatment will last between four months and a year.

Excessive Sweating – What is a Minor starch-iodine test?

The Minor starch-iodine test may be used to identify exactly where the sweat glands are.

The armpit is covered with iodine and then corn starch is applied.

The perspiration combines the iodine and glucose in the starch and turns black instantly.

This helps when administering Botox®, as we can concentrate injections in certain places.

Patients should not have used anti-perspirant for 24 hours prior to treatment and should not have shaved for 48 hours prior to treatment.

Excessive Sweating – Botox® isn’t working, what shall I do?

Firstly, you have to probe a bit deeper into why your Botox® isn’t working and discuss this at length with your practitioner.

Sometimes, the standard recommended dose administered is not enough to relieve your excessive sweating and you may need to be given more injections – if your hyperhidrosis is severe.

Botox® also needs topping up – you need follow-up treatment every 3- 6 months.

If you feel the excessive sweating calms down and then returns quite quickly, you may need Botox® more frequently.

Botox® treatments are usually very effective, so if you do not feel that the sweating is calming down, do ask about the possibility of having more injections.

This treatment is easily modified to help treat your specific needs.

Excessive Sweating – Is Botox® safe? Isn’t it a poison?

Botox® Botulinum toxin is a natural protein derived from Clostridium botulinum, the bacterium that gives us food poisoning, or botulism.

However, this toxin has been purified and refined, and is deemed safe and effective to use when administered by a specialist.

It presents no major harm to the body when treating excessive sweating or hyperhidrosis, and is only active in the specific area where it is injected; it does not spread throughout the body.

Excessive Sweating – in what areas is Botox® injected?

Botox® is only licensed in the UK for axillary excessive sweating / hyperhydrosis in the underarm.

Excessive Sweating – Clinical studies

Yes, a handful.

In one clinical study involving 322 patients with excessive sweating underarm, 81% of the patients receiving Botulinum Toxin injections achieved a greater than 50% reduction in sweating.

Excessive Sweating – What are the possible side effects of Botox®

If you experience any side effects following Botox® treatment, or if you have any concerns at all, please call Clare McLoughlin RGN INP  on 0800 8766322

The Botox® injections for excessive sweating can often cause small bruises although these disappear within a few days.

The muscles around the site of injection may also feel weaker than normal but again, these symptoms disappear within a week or two and should have no effect on your everyday life.

A small number of people experience an increase in sweating at sites other than the armpit.

The known side effects reported following treatment for hyperhidrosis with Botulinum Toxin Type A:

Very common side effects: 

Injection site pain.

Common side effects:

Pain where the injection was given; headache; numbness; hot flushes; increased sweating at sites other than the armpit; abnormal skin odour; itching; hair loss; lump under the skin; pain in the extremities, such as the hands and fingers.

Pain, Reactions and swelling, bleeding or burning and increased sensitivity pain where the injection was given.

Uncommon side effects:

Muscle weakness; feeling of weakness; muscle pain; problems with the joints; feeling sick.

Excessive Sweating – Are there any patients Botox® isn’t suited to?

Botox® for excessive sweating (hyperhidrosis) is not recommended for pregnant women or mothers who are breastfeeding.

It is also unsuitable for those with muscle or nerve disorders or on medications for nerve or muscle problems, such as Gentamicin and Quinidine.

Those with neuromuscular disease, Myasthenia Gravis or Lambert-Eaton syndrome are also unable to have this treatment.

Excessive Sweating – Does Botox® work?

Medical studies and patient testimonials have confirmed that Botox® reduces excessive sweating and improves lifestyle.

Of course, the level of reduction depends on each individual.

However, Botox® is not a cure for hyperhidrosis (excessive sweating).  As the nerve endings regrow, the sweating returns, but at this stage you should receive top-up injections to start the cycle again, keeping the area dry.

Excessive Sweating – Why is Botox® used?

The treatment of Excessive Sweating or Hyperhidrosis is a licensed use of Botox®.

All brands of Botulinum Toxin Type A block acetylcholine release at the neuromuscular junction and in cholinergic autonomic neurons.

Therefore axillary sweat glands are disconnected from their innervations, leading to a reduction in perspiration.

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