Hyperhydrosis

Hyperhidrosis is a condition characterized by excessive and uncontrollable sweating beyond that required for regulation of the body temperature. Primary hyperhidrosis is estimated at around 1% of the population, afflicting men and women equally. That number, however, does not reflect the true number of cases since the condition is not always diagnosed.

Primary hyperhidrosis must be distinguished from secondary hyperhidrosis, which can start at any point in life. For some, it can seem to come on unexpectedly. The latter form may be due to a disorder of the thyroid or pituitary gland, diabetes mellitus, tumors, gout, menopause, certain drugs, or mercury poisoning. Such secondary forms may have more serious consequences than just hyperhidrosis, making medical consultation advisable. Primary hyperhidrosis is found to start during adolescence or even before, and interestingly, seems to be inherited.


Hyperhidrosis can either be generalized or localized to specific parts of the body. Hands, feet, axilla (underarms), and the groin area are among the most active regions of perspiration due to the relatively high concentration of sweat glands; however, any part of the body may be affected. Patients afflicted with this condition often experience a reduction in their quality of life. Sufferers feel at a loss of control because perspiration takes place independent of temperature and emotional state.

A common complaint of patients is that they get nervous because they sweat, then sweat more because they are nervous. Other factors can play a role; certain foods & drinks, nicotine, caffeine, and smells can trigger a response.
Treatments for axillary hyperhidrosis (underarm sweating)

There is no known permanent cure for hyperhidrosis. Treatment options include topical and systemic therapies, iontophoresis, surgical intervention and BOTOX.


BOTOX therapy for excessive underarm sweating (axillary hyperhidrosis)

The most exciting development in the treatment for hyperhidrosis is BOTOX Injections.  Botulinum toxin can disable the sweat glands for 6-9 months, and sometimes longer, and help you regain a normal life, free of the stress and anxiety associated with excessive sweating.
What is BOTOX?

BOTOX® is FDA-approved natural, purified protein used to treat severe underarm sweating. It works by temporarily blocking the chemical signals from the nerves that stimulate the sweat glands. When the sweat glands don't receive chemical signals, the severe sweating stops. The positive effect from these treatments normally lasts at least 6 months. BOTOX has been available for over a decade and has been used to treat more than 1 million patients with various conditions, including spasticity, movement disorders and facial wrinkles. With FDA approval, the United States joins more than 20 other countries that have already approved the use of BOTOX for excessive sweating.



What are the BOTOX treatments like?

The use of botulinum toxin for the treatment of hyperhidrosis is most effective when performed by a physician who is received special training and who has experience with the procedure. Botulinum toxin injections require relatively little time, and do not demand any restrictions in work or leisure activities.

During the procedure, a very fine needle is used to inject small amounts of BOTOX just under the skin near the sweat glands responsible for excessive perspiration. Multiple injections are given based on our assessment of the area that needs to be treated. Shortly after the injections your sweating problems fade away.
Medications for axillary hyperhidrosis

Medications for hyperhidrosis include topical, oral and injectable therapies. Topical treatments range from  over the counter antiperspirants and powder to prescription strength aluminum chloride solution; ie, Drysol, MegaDry, Driclor.  Unfortunately, aluminum chloride solutions often cause skin irritation.

There are several oral drugs available to treat the condition. Anticholinergic drugs like Ditropan are available but many patients are unable to tolerate the drowsiness and dry-mouth associated with the drug .Since the disorder is often caused by or exacerbated by high-anxiety, antidepressant drugs can sometimes help alleviate symptoms.

Surgical intervention for axillary hyperhidrosis

Surgical intervention is also used sometimes. During endoscopic thoracic sympathectomy (ETS),  select sympathetic nerves in the chest are either cut or burned (completely destroying their ability to transmit impulses), or clamped (theoretically allowing for the reversal of the procedure). A second type of procedure involves sweat gland suction during which the sweat glands are permanently removed in a manner similar to liposuction.  Other treatments include iontophoresis  and percutaneous sympathectomy -  treatments where the nerve impulses are blocked by an injection of phenol.