Charles Perry, MD, Plastic Surgeon
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June 30, 2010

Sweaty Armpits, Sweaty Feet, Sweaty Palms – Hyperhydrosis: Is Botox Right for You?

Posted by Dr. Perry in Fillers and Botox, Sacramento Plastic Surgery

Sacramento,California. With the hot weather and thin clothing worn in Sacramento, we tend to notice body sweat a little easier, especially this time of year. Sweat is a useful lubricant in the arms and does help increase the tactile friction for fine grip in the hands and feet, and excessive sweating may help with thermoregulation however it may be socially embarrassing. For many antiperspirant reduces the embarrassment of body order and excessive sweating, however for some this isn’t enough. In fact in larger studies 1 out of 100 people sweat excessively. Excessive sweating of the axilla, hands or soles of the feet often referred to as Hyperhidrosis. Excessive sweating is socially embarrassing and psychologically disturbing especially for successful active people. (PRS: 110:222; 20002) (Primary hyperhidrosis has an unknown etiology while secondary hyperhdrosis can be due to antidepressants, hyperthyroidism, menopause, pheochromocytomas, and chronic infection and should be ruled out prior to treatment.)

If this is you or someone you know you may want to consider Botox or Dysport. It is amazing to see the difference after Botox treatment of hyperhidrosis. Plastic surgeons and cosmetic surgeons have been using Botox to treat crow’s feet and glabellar lines for years. Recently we have discovered that the chemodenervation of muscles of facial expression also reduces the sweat production as well. Selectively placed in certain areas of the body it can work wonders. No more sweaty palms and hand – shakes in the gym or the board room, no longer will you have to keep your arms to your sides. Botox as well as Dysport work well at decreasing the excessive sweat production found for affected individuals in the palms of the hands, armpits or axilla as well as the forehead or soles of the feet. You may be asking what are the downsides, well it does cost, and it requires a few needle pokes which can be painful in the ands and feet but seem to well tolerated in the axilla however the effects can last up to eight months in some studies. (Naumann, M., Flachenecker, P., Brocker, E. B., et al. Botulinum toxin for palmar hyperhidrosis. Lancet 349: 252, 1997.) For some their insurance may even covers the cost of the chemodenervation of the sweat glands. It is exciting to have such an easy fix to such an embarrassing problem. Previously treatment options included anticholinergic medicines that had many side effects such as dry mouth dizziness and constipation or chest/ thoracic surgery for thoracic sympathectomy and surgically removing the nerves to the armpits through liposuction. The best treatment for you should be decided between you and your physician or plastic surgeon. We look at best treatments as safe effective and inexpensive. Botox for hyperhydrosis seems to be an easy choice for the majority of people. For some Vaser liposuction done superficially may also be desirable. Have a great summer.

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