Involuntary Hyperhidrosis is a common and debilitating condition. The traditional treatment involved locally applied aluminium salts, orally administered anticholinergics, and if these were unsuccesful, removal of sweat glands (thoracic sympathectomy).
A thoracic sympathectomy involves the removal of the thoracic glands. This is effective in reducing the perspiration of the hands but less effective on involuntary hyperhidrosis. Vascular, nerve (chronic pain, Horner syndrome) and pleural (hemothorax, chylothorax) complications can occur and there is often compensatory sweating (back, legs) which results in low patient satisfaction.
Treatment involving botox injected under the skin of the armpit offers more promising results. This works by inhibiting the release of acetylcholine by the nerves that control perspiration. Reduction of this can result in an increased quality of life.
Even if they need to be repeated, botox injections are recommended as an initial treatment for severe hyperhidrosis.
Botox works by blocking the nerve impulses to the muscles. In addition to blocking the nerve impulses to the muscles, botox also blocks all nerve signals that are mediated by a chemical called acetylcholine. Acetylcholine is key to nerve functionality and this is why botox is used. It is a chemical that is released by the nerve endings and is used to carry the momentum of the nerve between the nerve terminal and the target of the nerve terminal.
The procedure can be completed in a matter of minutes and requires no special precautions. However, you must inform the practitioner if you are taking anticoagulants, antibiotics or suffer from a neuromuscular disorder.
The therapeutic effects of botox usually appear after a few days and last 3-6 months. Patients may notice small bruises at the site of the injection but these quickly disappear.
Possible side effects of the procedure include a weakness in the targeted or adjacent muscles. These side effects depend upon the dose of botox received and generally subside after a few days or weeks. The therapeutic effect of botox is temporary, therefore injections will need to be repeated if symptoms reccur. The frequency of injections is limited to one series of injections every three months. This helps to avoid and/or delay patients developing a natural resistance to the treatment. Between 1-3% of patients develop antibodies against botox that can reduce and/or eliminate the effectiveness of the treatment.