FREQUENTLY ASKED QUESTIONS
HOW DOES SWEATING TREATMENT WORK?
Hyperhidrosis means excessive sweating. Perspiration is a normal bodily function, controlled by the autonomic nervous system. Sweat glands are found in the skin throughout the body, however are present in higher numbers in the skin of the hands, feet, armpits and the genital regions. Perspiring is a normal physiologic response of the body when the internal or body temperature rises. This response is characteristically seen with either exercise, or exposure to high environmental temperatures. Stressful situations can also stimulate the autonomic nervous system which then increases sweat production by the glands highly concentrated in the hands, feet, or other regions. In most people, the autonomic response in the sweat glands to stress is not excessive. Unfortunately in patients with hyperhidrosis (approximately 2-3% of Americans), the autonomic stimulation of the sweat glands in response to stress is hyperactive.
Botox injections are used to disable the sweat glands. Botox acts by blocking acetyl choline release at the nerve endings that stimulate the sweat glands thus shutting down the sweat process on the injected
sites. The effects can last from 6-12 months depending on the site of injections. The procedure when used for underarm sweating has been approved by the FDA, thus giving new hope for people who after failing to respond to topical treatments were compelled to face surgery.*
Our doctors identify the hyperactive sweat area or areas with Minor’s Starch Iodine test and then, 10 to 15 sites, approximately 2 cm apart, are injected into each axilla. The whole procedure may take 20-30 minutes including the Botox preparation.*
50 units of Botox are usually needed for each axilla. The number of units required may vary depending on the individual patient. Visible results are usually seen in just a few days.*
Note: our doctor team uses Preserved Normal Saline for reconstitution of Botox which decreases the discomfort of the injections.
WHAT CAUSES UNDERARM SWEATING?
Excessive sweating, or hyperhidrosis, is caused by stimulation of the sweat glands by nerve endings which descend from higher centers in the brain. These nerves respond to emotional stresses; like intimate social situations, public speaking, physical stresses, and increased body temperature that comes with exercise or hot humid weather.
Most people with excessive sweating are bothered primarily when they are emotionally stressed, physically active, or over-heated. Botox® can prevent sweating for months by blocking the release of the neurotransmitter, i.e., acetylcholine, from the nerve endings, that causes the glands to produce sweat.
HOW IS BOTOX® ADMINISTERED?
Fifteen to twenty drops of Botox® are injected via a very small needle into the hair-bearing skin of each underarm. Normal activity can be immediately resumed, while heavy exercise should be avoided for several hours.
WHEN WILL BOTOX® TAKE EFFECT FOR HYPERHIDROSIS TREATMENT BROOKLYN?
Underarm sweating will be decreased by 90% within 48 hours and full effect will be seen within one week. There may be simultaneous disappearance of odor associated with decreased sweating, but this is not consistent.
HOW LONG DOES BOTOX® LAST?
Most patients will obtain the benefit of dryness with one treatment of Botox® for six to ten months.
WHAT ARE THE RISKS AND COMPLICATIONS?
Complications from injection into the axillary skin include tiny bruises which fade in a few days, and small persistent areas of sweating that may need a second treatment. There is no risk of numbness or permanent change in the axillary skin.
WHAT ARE ALTERNATIVE TREATMENTS?
Deodorants and antiperspirants
Aluminum chloride hexahydrate and salts are used in topical antiperspirant sticks, creams, lotions and
solutions. These prevent sweating by clogging the sweat ducts in the skin. These products can be
irritating with continued use and are largely ineffective in people with excessive sweating.
Anticholinergic drugs and tranquilizers
Oral medications currently used often provide relief but can cause dry mouth and blurry vision. Tranquilizers may minimize one's anxiety, but do little to diminish actual sweating.
Tap Water Iontophoresis
Battery-powered electrical devices that use water, consist of a moist pad and a prickly electrical current held against skin for several hours. Although they decrease sweating in some people, they are time consuming and they need to be repeated on a daily or a weekly basis. Iontophoresis is mildly effective for severe cases.
Surgery - ETS technique
Surgical alternatives include cutting the sweat glands from the skin of the underarms, therein leaving
visible scars and permanent numbness of the skin for decreased sweating. Neurosurgeons now use a fiberoptic surgical tube, to cut nerves in the neck which lead to the axillary sweat glands, i.e.
Risk and side effects of ETS procedure:
Infection, bleeding, and damage to the nerves.
Compensatory sweating: When this occurs the body "makes up" for the decreased sweating in the treated area by producing more sweat in other areas of the body. Approximately 85% of patients will experience some degree of compensatory sweating. It is important to note that compensatory sweating does not improve with time and is the main cause of dissatisfaction with the procedure.
Gustatory Sweating: Increased sweating when patients eat.
Horner’s Syndrome: Presents with unilateral decreased facial sweating, drooping of the eyelid, and enlarged pupils.
Pneumothorax: Air or gas can collect in the chest cavity, which may cause the lung to collapse.
For more information on Botox for Hyperhidrosis you may check https://www.botox.com/
*Results can vary based on individual conditions