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BOTOX  and Excessive Sweating

Excess sweating or Hyperhidrosis may  affect the whole body or  just specific areas. Hands, feet, forehead, scalp and armpit are the most disturbing areas.

In cases with whole body sweating, the underlying cause should be investigated first. Nervous system diseases, hyperthyroidism, lymphomas, drug side effects (some of the antidepressants), diabetes, gout, infectious diseases, menopause or anxiety can increase sweating. Daignosing the cause and appropriate treatment will be sufficient to solve this problem.

"Primary focal hyperhidrosis" is a term used for excessive sweating without an underlying disease. Excessive sweating will be used instead of this term, and the rest of my  article will focus on it.

This situation, which is seen in 3% of the society, creates serious problems in daily life. It has been demonstrated that the quality of life of these people is lower than that of psoriasis patients (Strutt, 2003). Fear of hand shaking and hugging, having to change clothes frequently, avoiding physical activity may cause anxiety, depression, difficulty in establishing new relationships,

Diagnostic criteria for excessive sweating:

  • Regional excess sweating that has been going on for more than 6 months,

  • Without any identifiable cause ,

  • Any 2 of the following findings are present:

    • Bilateral and symmetrical involvement,

    • Causing limitations in daily life,

    • At least 1 attack per week,

    • Appearance before the age of 25,

    • Familial tendency,

    • No sweating during sleep.

The effectiveness of Botox on excessive sweating was demonstrated in the early 2000s. There are many scientific publications that demonstrate the effectiveness of treatment. In 2004, FDA approved BOTOX  for the treatment of severe primary axillary hyperhidrosis.

Botox injections to:

Armpit is the most common application area. The application is not painful and topical anesthetic creams provide sufficient anesthesia.

Hands and feet are quite painful in contrast. Nerve blocks or sedation anesthesia are necessary for pain free injections.

Forehead and scalp can be done comfortably with anesthetic creams.

The effectiveness of the treatment lasts longer than cosmetic applications. The average efficacy period is 7-9 months. Supportive treatments such as aluminum chloride solution or iontopheresis prolong this period.

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Direct excision of sweat glands or reduce them by liposuction may offer permanent solution for armpit sweating. Removal of direct excision of sweat glands has lost its popularity today. The main drawbacks of the technique are scar formation in a difficult-to-hide area and delayed healing period. Liposuction can reduce the numberof sweat glands from extremely small incisions and complications are rare. 

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Botox caused a revolutionary change in the treatment of excessive sweating. It is a simple and effective approach to overcome this emotionally and physically disturbing situation.

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