So we are well into pumpkin spice season but for all of my Georgia friends—fall has not quiiiite arrived (even though I am pretending.) Its still hot and humid and if sweating is an issue for you—lets chat about what can be done!
Hyperhidrosis is defined as sweating in excess of what is required to regulate your body temperature. Many people suffer from anxiety due to their excess sweating. Shaking hands, giving a (zoom) presentation, or just having drinks with friends becomes a worry. With a background in dermatology as well as aesthetics, this is something I have been treating over the years with various modalities. However, botox has provided my patients with the most relief. But let’s review!
Treatments
Aluminum chloride antiperspirants are a good place to start. They are short acting and typically require nightly application. You can use this on hands and feet as well if needed. The pros are it is easy and cost effective. The cons are that you have to continue to reapply and in some patients doesn’t work well (or they are unable to apply nightly as needed).
Non invasive procedures such as Miradry, use microwave energy to destroy the sweat glands. Pros: typically 1-2 treatments necessary to provide desired results. Sweat glands don’t “grow back” so in theory it is a permanent solution. Approximately 82% reduction of sweat glands. Cons: It can only treat underarms (not hands or feet). Discomfort for 2-3 weeks after procedure.
There are surgical procedures that are in my opinion a last resort. They typically will require excision of the sweat glands or a procedure called endoscopic transthoracic sympathectomy (ETS). Thats a mouthful. This is the surgical removal of sympathetic nerves, whose impulses stimulate the sweat glands. Sympathectomy is considered a last result, as it has high risk of complication and produces irreversible compensatory sweating, which means sweating heavily in other areas. The pros of this procedure are that it is a one time thing, if it works it can work great. The cons of this procedure are the cost, how invasive they are, and there are still high recurrence rates or compensatory sweating. (Ie you can still have problems with sweating afterwards).
Enter my favorite treatment for sweating: Botulinum Toxin, otherwise known as “Botox”. Botox inhibits the release of acetylcholine preventing hyper stimulation of sweat glands. In English: it stops the sweating on a cellular level. Pros: no maintenance at home. Not as aggressive as surgery. 75% reduction of sweating. We can treat the hands, feet, underarms. Less discomfort than Miradry while offering similar results. As I like to put it, its “easy”. Cons: it wears off in around 6-9 months. Not “destroying” sweat glands just inhibiting them. So I typically recommend twice yearly treatments for my patients.
Limitations
As with most cosmetic treatments, these procedures including botox cannot be performed with pregnant or breastfeeding. They should also not be utilized with sweating is due to an underlying condition.
So now what?
Schedule a consult! If you find that you are one of these people suffering from hyperhidrosis and did not know there were good options out there-lets talk! Botox may be a great option for you to improve your quality of life. And isn’t that what it is all about?