Treatment for Excessive Sweating (Hyperhidrosis)

Hyperhidrosis is a condition characterized by excessive sweating, which can occur in any part of the body, but most commonly affects the underarms, palms, and soles of the feet. The exact cause of hyperhidrosis is not well understood, but it is thought to be related to overactivity of the sympathetic nervous system, which controls the sweat glands.

The sympathetic nervous system is activated during times of stress or emotional arousal, leading to an increase in sweat production. In individuals with hyperhidrosis, the sympathetic nervous system is excessively active even during times of normal activity or rest, resulting in excessive sweating.

There are various treatment options for hyperhidrosis, including:

1. Antiperspirants: Over-the-counter antiperspirants can be used to temporarily reduce sweating, but they may not be effective in controlling severe cases of hyperhidrosis.
2. Topical medications: topical aluminum chloride can be used to reduce sweating, but it can cause skin irritation.
3. Oral medications: Anticholinergic medications can be used to reduce sweating by blocking the action of the neurotransmitter acetylcholine on the sweat glands.
4. Iontophoresis: This treatment involves passing a mild electrical current through water in which the affected area is submerged. It can be effective in controlling sweating, but it may not be suitable for all patients.
5. Botox: Botulinum toxin (Botox) is a medication that can be injected into the affected area to temporarily block the nerve impulses that stimulate the sweat glands.
6. Infini: is a non-surgical treatment that uses radiofrequency energy to target the sweat glands and reduce sweating. The procedure is minimally invasive, and there is minimal recovery time.
7. miraDry: is a non-invasive treatment that uses microwave energy to destroy the sweat glands in the underarms. It can provide long-term relief from underarm sweating, but it may cause temporary pain and swelling, and in rare cases, numbness or tingling in the underarms.

Overall, the best treatment option for hyperhidrosis will depend on the individual patient, and may include a combination of treatments.

In summary Hyperhidrosis is a medical condition characterized by excessive sweating caused by overactivity of the sympathetic nervous system. It can affect any part of the body but usually affects armpits, palms, and soles. There are various treatment options include antiperspirants, topical medications, oral medications, iontophoresis, Botox, Infini and miraDry. Each treatment has its own advantages and disadvantages, and the best treatment will depend on the individual patient.

What the published evidence on Botox for sweating shows

Only papers whose article title itself contains the requested brand name are included below. Product names mentioned only in the abstract, keywords or methods were excluded.

Severe primary axillary hyperhidrosis is one of the established indications for Botox, and evidence-based reviews of its non-cosmetic head and neck uses report level 1 evidence for the related glandular indication, sialorrhoea, through the same mechanism of blocking acetylcholine release at the gland. [1] [2] [3]

Dr Gerard Ee consults and performs this treatment at The Clifford Clinic, 50 Raffles Place, Singapore.

References

1. Rouientan A, Alizadeh Otaghvar H, Mahmoudvand H, Tizmaghz A. Rare Complication of Botox Injection: A Case Report. World J Plast Surg. 2019;8(1):116-119. doi:10.29252/wjps.8.1.116. PMID 30873373.
2. Persaud R, Garas G, Silva S, Stamatoglou C, Chatrath P, Patel K. An evidence-based review of botulinum toxin (Botox) applications in non-cosmetic head and neck conditions. JRSM Short Rep. 2013;4(2):10. doi:10.1177/2042533312472115. PMID 23476731.
3. Awan KH. The therapeutic usage of botulinum toxin (Botox) in non-cosmetic head and neck conditions – An evidence based review. Saudi Pharm J. 2017;25(1):18-24. doi:10.1016/j.jsps.2016.04.024. PMID 28223858.