Our skin is made up of several components including sweat glands, hair follicles, oil-producing sebaceous glands, blood vessels, and nerves. Sweat glands are controlled by nerves that are in-turn controlled by certain bodily functions like breathing, food digestion, heart rate, body temperature, blood pressure, and response to stress. For example, when your body temperature goes up, your body activates the nerves to the sweat glands to secrete sweat and cool you down.
Botox treats excessive sweating by blocking the signal between the nerves and the sweat glands. The agent binds to the actual nerve ending and blocks the release of neurotransmitters that communicate with the sweat gland.
In 2004, Botox injections were approved to treat excessively sweaty armpits, or axillary hyperhidrosis. Some doctors also use the drug for excessively sweaty feet and palms. These treatments involve focused injections into the affected areas and the effects last approximately six months.
Botox is usually considered when topical treatments such as antiperspirants, iontophoresis and medications have been unsuccessful. Botox is only effective in treating small areas and is therefore not a viable option for treating generalized hyperhidrosis.
How Does It Work?
Sweat glands are in the skin itself. When Botox is injected into the skin, it blocks the chemical messenger which would otherwise cause sympathetic nerves to reach the sweat glands, turning sweat ‘on’. Without the chemical message, the glands cannot turn on the sweating.
Even though Botox permanently blocks the nerve endings so sweat cannot be produced, within 6-12 weeks your body starts to produce new nerve endings causing mild sweating to return. Within 4-12 months, all new nerve endings will have been produced, turning all of the sweat glands on again. Sweating returns to normal this time.
You will have a consultation with your physician before the treatment to help to determine where sweating occurs at its worst, and to review your medical history to ensure that you do not have any health problems that Botox may interfere with or worsen. You will then be told the possible side effects of the procedure to forewarn you of any unwanted symptoms.
The procedure can be done in a regular exam room or in our surgical suite. It is important to note that you will be awake during the procedure. Most treatments are completed within 10-15 minutes and usually only a topical anesthetic cream containing lidocaine is used.
The site of injection will first be cleaned to avoid infection. Once the arm pit area is numb from the lidocaine cream, a thin needle is used to inject the Botox under the arms (axillae). Each armpit is administered around fifteen injections which are completed relatively quickly.
- It is common for it to take up to 7 days for the Botox to start working properly. It is important not to expect complete results right away.
- Avoid massaging the area or putting pressure on the injection site for a few days
- Avoid strenuous activity.
- The site may be a little painful and small bruises can form, but these symptoms go away within a day or two.
Is Botox safe?Although Botulinum A is a natural protein derived from a toxin (Clostridium botulinum), which has been purified and refined. Botox is considered safe, effective and presents no major harm to the body when treating hyperhidrosis. It is only active in the specific area where it is injected, and does not spread throughout the body.
Does it hurt?To help relieve the pain and discomfort, our patients are offered a lidocaine anesthetic topical cream. Some patients opt to do the treatment without any anesthesia. The choice is completely up to the patient.
Does it work?Medical studies and patient testimonials have confirmed that Botox, when administered properly, reduces sweating in the treatment area, however, Botox is not a cure for hyperhidrosis. As the nerve endings regrow, the sweating return. It is necessary to receive another round of injections to start the cycle again, keeping the area dry. Sometimes sweat glands can be missed out and so you may experience a small level of sweating in some areas of your armpits. This is easily solved with top-up injections at your next appointment and you can bring it to the physician’s attention so they can concentrate on these areas.
Are there any possible side effects?
- Many patients experience muscle weakness, but this wears off eventually.
- Some patients have experienced an increase in sweating in another part of the body.
- Patients have reported flu-like symptoms, tiredness and blurred vision, and possible arm and neck ache. These are all temporary symptoms and should disappear in a few days, and not everyone experiences them.
- There are no severely uncomfortable sensations or effects which should affect your daily life and there are rarely any complications
Are there any patients Botox isn’t suited to?
- Botox for hyperhidrosis is not recommended for:
- Women who are pregnant or breastfeeding.
- Anyone with muscle or nerve disorders or on medications for nerve or muscle problems.
- Those with neuromuscular disease, Myasthenia Gravis or Lambert-Eaton syndrome