Hyperhidrosis is excessive sweating with no internal or external causes present. The primary treatment sites are areas with a high density of eccrine sweat glands such as armpits, soles of the feet, palms of the hands, forehead, and neck.
Treatment is indicated if conventional topical measures such as tannic acid and deodorant with aluminum chloride hexahydrate fail to adequately reduce sweat production and the condition causes the patient considerable distress. The affected areas are first delineated using the “Minor Test”. Lugol’s solution (iodine/potassium iodide solution) is applied to the affected area with a swab and then dusted over with cornstarch. After 3-5 minutes the sweat producing skin areas become highly discolored independent of any thermoregulation from exercise or other factors. With a positive Minor test, the areas can then be treated according to the now defined areas of excessive sweat. Usually, the area of highest sweat production is identical to the area of hair growth.
Treatment with botulinum toxin A leads to inhibition of the sympathetic cholinergic nerve fibers and reduces or prevents sweat production. Intradermal injection of Botox is one of the most effective methods of reducing excessive sweat production. Treatment effects can last anywhere from 6-18 months depending on the person and number of units used to treat. It is recommended to use 50-100 units per area being treated depending on the size of the area.
Treatment is very quick and painless, about 15-20 minutes after being numbed with a little topical cream. For anyone who is extra nervous or worried about the pain we also have “laughing gas” available in each treatment room that can be used to help make the procedure even more comfortable. If there is an area that is more sensitive it would probably be the hands and soles of feet, extra numbing time and laughing gas can be used in these areas. There is no downtime from this procedure. The full effect of treatment will take place in about 3-6 weeks.