The social embarrassment associated with excessive sweating can be profound. Whether the problem is primarily underarm sweating or palmar sweating, or both, the impact on normal social interaction can be significant. Some individuals with excessive underarm sweat production wear special pads and garments to try to 'stem the tide'. Many with excessive palmar sweating avoid shaking hands at all costs.
For the first time there is safe, reliable and well-tolerated means of reducing sweat production that is quickly and easily administered and lasts for months: BOTOX ® injection. BOTOX ®, approved now for several years for the treatment of facial wrinkles, is now FDA-approved for the treatment of hyperhidrosis.
The chemical that is released by nerve endings to stimulate muscle contraction, acetylcholine, is the same chemical that causes sweat glands to produce sweat. BOTOX ® works, in both cases, by preventing the release of this chemical from nerve endings, thereby blocking muscle contraction (when injected in the area of facial muscles) and blocking excessive sweat production (when injected into the skin of the underarms or palms).
We are currently treating patients with excessive sweating of both the palms and the underarms. The treatment on average lasts about six months, which is somewhat more prolonged that the effect of BOTOX ® injection for facial wrinkles. To reduce the discomfort associated with multiple injections, the skin of the treated area is cooled with ice packs immediately prior to BOTOX ® administration. For injection of the palms, the treatment area can be numbed completely by the administration of a local anesthetic adjacent to the palmar sensory nerves.
Many of our patients come in for treatment on a regular basis, usually about twice a year, so that this frustrating problem is almost completely eliminated from their lives. Others come in advance of important social engagements, such as weddings and reunions, and before important public appearances. Our patients who have undergone BOTOX ® for hyperhidrosis often state that the treatment is life changing.
