Treatment to Reduce Excessive Sweating/ Hyperhidrosis

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Overview

Sweating is necessary to control body temperature during times of exercise and in warm/hot surroundings, and is a normal response to a rise in temperature or anxiety. Sweating is regulated by the sympathetic nervous system. In about 1% of the population, this system is revved-up and works at a very high level, causing sweating to occur at inappropriate times, far in excess of the amount necessary to maintain normal body temperature. It can occur in many different areas of the body, and the condition is known as Hyperhidrosis, which means 'excessive sweating'. It affects both sexes equally, and all races.

What is it & How does it Work?

Botulinum toxin, often referred to as Botox® is a naturally occurring protein produced by the bacterium Clostridium Botulinum. The toxin blocks the transition of chemical messages sent from the nerve to cause the muscle to contract.

Botulinum toxin is injected into the affected area, and works by blocking the nerves that supply the sweat glands, stopping them from producing sweat.

Botulinum toxin injections work well as a safe and effective treatment, with minimal side effects, but top-up treatments are usually required after about six or seven months and it is not easily available on the NHS. Before seeking treatment with botulinum toxin, make sure you have had a proper diagnosis from your GP and perhaps tried other options available on The NHS.

Licensed brands of botulinum toxin A include,’ Botox®, Azzalure®, Bocouture®, Xeomin®, and Dysport®. All botulinum toxins are prescription only medicines (POM) and can only be prescribed by doctors, dentists, prescribing nurses and pharmacists with a prescribing qualification, following a face to face assessment and consultation with the qualified prescriber.

Perspiration normally diminishes substantially within 48 hours and the effects of treatment can last up to 7 months. Patients will notice considerable change and experience the full effects of the treatment within 10 days of having the injections.

You will be advised to keep the target muscles active for a few hours and to avoid extremes of heat or cold & vigorous exercise for 4-6 hours.

Common areas for treatment include:

Under arms
Hands
Feet
Chest
Groin
Facial areas

Your practitioner will take a detailed medical history and an assessment of your needs and expectations to ensure this is an appropriate treatment for you. Botulinum Toxin (commonly referred to as Botox) is a prescription only medicine. This means that you MUST have a face to face consultation with a licensed prescriber to assess whether you are suitable for treatment. *This MUST be with a doctor, nurse prescriber, dentist or a prescribing pharmacist.

Except in exceptional circumstances this is not a treatment recommended for those under 25 or over 65.
For best results skin should be in good condition and the target lines not too furrowed. Your practitioner will assess your suitability and advise.
Botulinum toxin cannot be given to pregnant or breast feeding women.
Not suitable for patients with certain neurological disorders.
Not suitable if you are currently taking certain medicines.
If you have previously experienced adverse reactions to any botulinum toxin treatment.

With any injectable treatment;

Treatment is not recommended if you are suffering from any skin infection in or near the treat- ment area or are unwell in any way (even a cold).
If you are taking any medicines which affect bleeding, such as aspirin or warfarin.
If you are currently or have recently completed a course of Roacutane (acne treatment) in the last 18 months.
If you are pregnant or breastfeeding.

Caution

If you are planning to attend an important event and any adverse event described would be unacceptable to you, discuss with your clinician in advance of having treatment.
Some over the counter medicines and supplements can also affect bleeding (make you more prone to bruising) as can alcohol- which should be avoided the day before and after treatment.
Vigorous exercise, sun exposure, sun beds, sauna should be avoided for 48 hours, or as advised by your clinician, after treatment.

If you are at all concerned about symptoms you were not expecting or not happy with, please contact the practitioner for advice. If necessary an appointment will be made for you to be seen.

All treatments carry a degree of risk. All risks and complications will be discussed with you at consultation and prior to any treatment being agreed. Botulinum Toxin should be administered by a healthcare professional with specialist training. Side effects include, but are not limited to;

Bruising
Swelling at injection sites
Redness at injection sites
Headache or a sensation of ‘tightness’ or ‘heaviness’

Adverse events are uncommon, usually occur within a few days of treatment and are expected to be temporary, usually resolving spontaneously within weeks. Your practitioner will provide aftercare advice designed to minimise risk and promote speedy recovery from any expected side effects.

A very fine needle is used and generally this treatment is not painful and can be well tolerated with no anaesthetic. Ice may be helpful in numbing the skin for nervous patients as well as reducing the risk of a bruise.