Botox and Excessive Sweating

Hyperhidrosis is a condition characterised by excessive or abnormal sweating. This excess or drip sweating is most common under-arms but it can also occur on the extremities – soles of the feet and palms of the hands – as well as the face. When sweat glands are functioning normally they are activated by a rise in body temperature as part of the body’s cooling mechanism. In cases of hyperhidrosis the sweat glands activate more frequently and with no apparent stimulus. Sweating when it isn’t hot or sweating without exertion is typical – as is sweating through clothes.

Hyperhidrosis can be the result of a systemic medical issue but generally occurs in isolation in otherwise healthy people. Specifically, it’s the result of an over-active sympathetic nervous system, a branch of which runs along the spine and stimulates the eccrine glands, responsible for sweat production throughout the body. While certain hormone changes can trigger hyperhidrosis, in most cases there is no identifiable cause. Thought to affect approximately 1% of the general population, it has a higher incidence in women than men and often begins in puberty when the associated glands begin to function. Most cases report onset before age 25. Under-reporting is a factor in gauging the true prevalence as many people are embarrassed to seek help and / or accept the condition as irreversible.

Hyperhidrosis is usually resistant to anti-perspirants and in the past little could be done bar frequent clothing changes. Today, Botox has been approved as a treatment for severe under-arm hyperhidrosis when prescription anti-perspirants have failed. (Botox treatment is yet to be approved for other areas like hands, feet and face, but is sometimes carried out in an off-label capacity. Talk to your practitioner about their off-label policy.) Botox works by inhibiting nerve function or interrupting communication between the brain and the sweat glands – effectively preventing perspiration.

Botox is injected just under the skin in a grid-like pattern across the affected area. You may be offered a topical anaesthetic or ice to ease the pain, however pain in the under-arm area is reportedly minimal (One concern regarding Botox treatment on the hands and feet is the increased sensitivity of these areas). There is little if any down-time and results should be almost immediate.

As with all Botox treatments the benefits are specific to the injection site only and have a limited lifespan. Under-arm injections are typically effective for three to six months with a very high success rate for the duration. Injections in the hands and feet are also successful but the effects wear off more quickly. Facial or forehead injections have a lower success rate but can be expected to last for around five months. The duration and success of any Botox procedure is, of course, different for each individual, and while the need for repeated treatment means it is not a definitive cure for hyperhidrosis, Botox has proved a significant and life-changing leap forward in the management of a bothersome and persistent condition.

Santi London, 33 Thurloe Street, London SW7 2LQ Appointments: 0207 5847000

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