Botox® for treatment of Hyperhidrosis
All of us experience sweating, and we know how uncomfortable it can be when you sweat through clothing. Sweating is the body’s natural response to help regulate its temperature. Some of us, however, experience an excessive amount of sweating. In the medical community, this is known as hyperhidrosis. It is a common disorder that can affect the face, underarms, palms, soles of the feet and groin. Hyperhidrosis is when sweating exceeds the body’s normal requirements for cooling. Primary hyperhidrosis has no obvious cause whereas secondary hyperhidrosis has an underlying cause such as an endocrine disorder, secretory tumor, sympathetic nervous system disorder or neurological/psychiatric disorder.
Luckily, there is treatment for excess underarm sweating. Botox® is FDA approved for severe primary axillary (underarm) hyperhidrosis and is typically used when topical or oral agents have provided inadequate relief of symptoms.
How Does Botox® Decrease Sweating?
As the body temperature rises the nervous system activates the sweat glands to help cool itself. In patients with hyperhidrosis the nerves that activate the sweat glands are overactive. Botox® acts locally by temporarily blocking the secretion of the chemical that is responsible for activating the sweat glands thereby shutting them “off,” preventing sweating in the local area.
Is It Safe To Stop Sweating?
Sweat glands are needed to help the body cool itself and regulate temperature. There are over 2 million sweat glands in the body and less than 2% of them are found in the underarms. By eliminating or temporarily blocking the underarm sweat glands from functioning the body still maintains the ability to cool itself thru the other sweat glands that are not treated.
How Many Units Of Botox® Are Needed To Treat Underarm Sweating (Axillary Hyperhidrosis)?
For optimal results, 50 units of Botox® are typically administered to each underarm. Individual results may vary however; at this dose results will typically last 6+ months. Using fewer than 50 units per underarm will generally result in relief of symptoms for only a few months.
What Are The Common Side Effects Of Botox®?
- Pain or bruising at the injection site
- Flu-like symptoms
Serious side effects of Botox® injections are extremely rare and include muscle weakness in the entire body, visual difficulty, difficulty breathing and loss of bladder control. Typically these side effects occur as a result of large doses of Botox® combined with where it has been injected. It is therefore important to notify your provider if you have had Botox® for other aesthetic or medical reasons.
Does Insurance Cover Botox® for Excess Underarm Sweating?
Botox® is FDA approved for excess underarm sweating, known as primary axillary hyperhidrosis. Only select cases are covered by insurance. Please contact your insurance company to see if you are covered.
What Other Treatments Are Used For Excess Underarm Sweating?
Typically general antiperspirants are ineffective in treating excess underarm sweating. First line over the counter antiperspirants that contain aluminum chloride provide relief for some. Others find prescription strength antiperspirants that contain aluminum chloride hexahydrate (Drysol) more effective.
When topical agents have failed, oral anticholinergic medications may help reduce sweating. However, they are generally not well tolerated due to side effects which include dry mouth, blurred vision and urinary retention.
Iontophoresis uses water to conduct an electric current to the skin weakening the sweat glands. A series of treatments is required for optimal results along with maintenance treatments.
Laser treatments may also be used to treat axillary hyperhidrosis. miraDry and lasers use energy to create heat in the area of the sweat gland to permanently eliminate them.
Surgical procedures are also available for excess underarm sweating. Thoracic sympathectomy (removal of the nerve that controls the sweat gland) is a surgical procedure that is reserved as a last resort.
Can Botox® Be Used To Treat Other Forms Of Excess Sweating Elsewhere?
Botox® can be used to treat excessive sweating to other areas such as the forehead, palms of the hands and soles of the feet however injections may require a nerve block for the hands and feet due to discomfort during the treatment. Results in the above areas generally do not last as long as the underarms.
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