Excessive Sweating or Hyperhidrosis

Hyperhidrosis means excessive sweating. Sweating is an important function, which enables the body to lose heat; however, people with hyperhidrosis produce sweat in amounts far greater than needed to control their temperature.
There are two main types of hyperhidrosis:

• Focal hyperhidrosis is the more common type involving excessive sweating on the feet, hands and, in about 30–40% of cases, the armpits. Botox® is recommended for the treatment of focal hyperhidrosis affecting the armpits (axillary hyperhidrosis) when other treatments have not worked.
• Generalised hyperhidrosis affects the whole body. It is much less common and is usually caused by another illness such as an infection, diabetes or when the thyroid gland is overactive. The excessive sweating usually stops when the illness is treated.

It has been estimated between 1-3 in every 100 people has some form of hyperhidrosis. It typically starts during childhood or soon after puberty.

It’s not known what causes hyperhidrosis and why it affects some people but not others. There is thought to be a genetic component as approximately 1 in 3 people with hyperhidrosis have a relative with a similar problem.

Hyperhidrosis occurs by the over activity of one type of sweat gland, the eccrine gland. These glands are found virtually all over the body surface but they are concentrated on the palms of the hands, the soles of the feet and in the armpits.

Many things can trigger normal sweating and this is also true for hyperhidrosis – it’s just the amount of sweating that varies.
Examples of triggers include:

• exercise
• heat or cold
• alcohol, coffee or tea, smoking, hot or spicy food
• stress, anxiety or strong emotions
• certain times of the day

If you have hyperhidrosis, you may produce a large volume of sweat. This means that your hands, feet, chest or armpits (depending on which part of the body is affected) may be constantly damp. This can make normal everyday activities more difficult to carry out and it may be causing you embarrassment at work or socially.

It is not true that hyperhidrosis causes body odour – the smell that some people think is due to sweating is in fact caused by bacteria if sweat remains on the skin for a long time.

There are several simple self-help measures that may make a difference to your hyperhidrosis. These are:

• Choose clothing that will keep you cool. Natural fibres are cool but they absorb sweat and can remain damp, some synthetic fibres are warm but they draw sweat away from the body and feel dry. Consider having a change of clothing available during the day.
• Keep your work environment cool and well aired.
• Avoid the food and drinks that trigger sweating. These will be different for everyone but you will probably know what causes problems for you.
• Reduce stress, tension and anxiety. These are common problems for everyone but coping with hyperhidrosis may be increasing your stress levels. Think about how you can reduce stress during the day, plan your activities carefully and make time to relax.
• Pay attention to your personal hygiene. Odour can be reduced by taking frequent showers. Although this will not be convenient for people who constantly sweat, it is an effective and simple measure to take.

Botox® is a treatment given by injection into the skin. It is recommended for the treatment of axillary hyperhidrosis – excessive underarm sweating – and it has been used for many years to treat muscle spasm affecting the eyes, face and neck. Botox^® is also used to relieve muscle spasm in children with cerebral palsy.

Botox^® is a very pure preparation of a protein called Botulinum Toxin type A. When small doses are injected into the skin, Botox^® blocks the actions of the nerves that supply the eccrine glands; this prevents the glands from producing sweat. Botox^® blocks the nerve endings, however after approximately 6 – 12 weeks, new nerve endings grow to replace them. This means that the effects of treatment last for several months but will eventually wear off.

Using a very fine needle, we will inject a small amount of a Botox^® solution into 10 -15 places about 1cm apart and spread evenly in each armpit. Sometimes a dye is used to show up the areas where sweating is greatest and where the injections should be placed.

A course of treatment takes about 30 minutes.

You should notice some change for the better within a week of your treatment.

Different people have different responses to treatment. In a clinical trial, sweat production was reduced by 83% 1 week after treatment. Furthermore, sweating was reduced by at least half in 95% of patients. Your next treatment can be given when the effects of the first course wear off, this usually happens after 4 – 7 months.

We will advise you about when to return for further treatment.

The cost of your treatment will depend on the size of the area to be treated and the number of injections you will need. We would recommend that you a book a free initial consultation – this gives us an opportunity to review your case, find out how hyperhidrosis has been affecting your life, and for you to ask questions. We can then give you a breakdown of the treatment costs.