Hyperhidrosis:
Sweating is the body’s way of cooling itself and is a normal response to a hot environment or intense exercise. However, excessive sweating unrelated to these conditions can be a problem for some people. Those with constantly moist hands may feel uncomfortable shaking hands or touching, while others with sweaty armpits and feet may have to contend with the unpleasant odor that results from the bacterial breakdown of sweat and cellular debris (bromhidrosis). People with hyperhidrosis often must change their clothes at least once a day, and their shoes can be ruined by the excess moisture. Hyperhidrosis may also contribute to such skin diseases as athlete’s foot (tinea pedis) and contact dermatitis.
Incidence:
Hyperhidrosis in general and axillary hyperhidrosis (excessive sweating in the armpits) in particular are more common in the general population than was previously thought. A group of dermatologists in Virginia reported in 2004 that 2.8% of the United States population, or about 7.8 million persons, have hyperhidrosis. Of this group, slightly more than half (4 million persons) have axillary hyperhidrosis. One-third of the latter group, or about 1.3 million persons, find that the condition significantly interferes with daily activities and is barely tolerable. Only 38%, however, had ever discussed their excessive sweating with their doctor.
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 when they are emotionally stressed, physically active or over heated.
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:
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. endoscopic sympathectomy. This approach includes the risk of possible nerve damage to structures in the neck which can result in paralysis of the arm, loss of sensation, and permanent dilation of the pupil of the eye. - 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.
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Hyperhidrosis of the palms
- How is Botox® given?
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?
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, and the risk of temporary muscle weakness is remote.
- Who are good candidates for Botox® Don’t Sweat?
- Anyone with an increased or problem of underarm sweating.
- Anyone who worries about sweating through their clothes.
- Anyone who would like to wear fine fabrics, sleeveless shirts and blouses, or who would like to take their jacket off.
- Anyone working in close contact with others such as hairstylists, nurses, physicians, dentists, hygienists, and flight attendants.
- Anyone working in hot conditions, such as models, television personalities and chefs.
- Anyone making public presentations, including: executives, attorneys, and salesmen.
In addition to excessive sweat production, the texture and color of the skin itself may be affected by hyperhidrosis. The skin may turn pink or bluish white. Severe hyperhidrosis of the soles of the feet may produce cracks, fissures, and scaling of the skin. This picture depicts a case of Hyperhidrosis pedis where Dr. El-Attar treated the right foot only. After 3 weeks you can see the difference in dryness and skin textural changes compared to the left foot which was treated on later date
Botox® Don’t Sweat is the answer for problem sweating!
If you are interested in learning more about Botox® Don’t Sweat, please contact our office at Derma Laser Centers of New Jersey at 
609-631-8558
or call Toll free 1-866-38-DERMA
Tags: aluminum chloride hexahydrate, axillary hyperhidrosis, cellular debris, contact dermatitis, deodorants, dermatologists in virginia, emotional stresses, excess moisture, humid weather, intense exercise, moist hands, nerve endings, nj doctor, physical stresses, skin diseases, sweat glands, sweaty armpits, tinea, united states population, unpleasant odor
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