How is Botox administered to treat hyperhidrosis?
Patients with hyperhidrosis of the underarm may be required to leave the armpits unshaved for a few days prior to the procedure. The procedure can be started after the hyperhidrotic area had been sanitized, anesthetized, and defined using standard staining techniques such as the Minor´s iodine-starch test. The reconstituted toxin solution is then administered just under the skin using a very fine needle. It is best that the toxin solution is dispersed evenly throughout the hyperhidrotic area in a grid pattern, approximately 1 to 2cm apart. The exact dosage may differ depending on the treatment areas.
How is hyperhidrosis managed?
Most patients resort to applying prescription-strength antiperspirants as their first line of treatment against excessive sweating. Once applied topically, aluminum chlorohydrate (active ingredient) present in the antiperspirant will mix with the sweat excreted and form superficial plugs in the pores. Blocked pores relay negative feedback mechanism to the body, resulting in temporary reduced production of sweat.
Besides clinical-strength antiperspirants, patients with hyperhidrosis may also be prescribed with anticholinergic drugs (e.g. benzatropine, methantheline, oxybutynin, propantheline, etc.). The mechanism of action of these drugs is by blocking the activity of the neurotransmitter acetylcholine in the central and peripheral nervous system, which leads to less sweat excretion. That being said, these drugs can cause undesirable side effects such as urinary retention, dry mouth, visual disturbances, and constipation.
Patients with severe cases of hyperhidrosis may choose to undergo surgical removal of sweat glands instead. This procedure can be done via axillary liposuction, retrodermal curettage, and suction. Though this surgical procedure has a high success rate (80%), the patient’s condition can still regress due to regeneration of nerve fibers. Patients who are unable to obtain adequate relief via medication or antiperspirants, and do not want to undergo a surgical procedure, can opt for Botox injections instead. This popular brand of botulinum toxin type A t is manufactured by Allergan, a distinguished pharmaceutical company. Botulinum toxin is a potent neurotoxin that is extracted from Clostridium botulinum bacteria. Despite its toxicity, Botox is formulated to contain only the purest form of toxin, which comes in a therapeutic amount. It is classified as an effective neuromuscular paralytic agent that inhibits the release of acetylcholine. The treated regions will then remain sweat-free until the injected toxin is metabolized.
Who are the ideal patients to receive Botox injections?
Patients with hyperhidrosis who wish to receive Botox injections must be free from the following health conditions:
- Hypersensitivity to any of the components in Botox;
- Active skin disorders (e.g. inflammations, infections, broken skin, wounds, etc.) on proposed treatment areas.
How long are the results expected to last?
Patients should notice clinical improvements to their condition about a week after the treatment session, with full effects of the botulinum toxin lasting for about 4 to 7 months and even up to a year. However, the duration of action of Botox varies depending on the patient’s physiology (e.g. health status, age, lifestyle habits, etc.) and the amount of Botox injected.