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Injections for Excessive Sweating

Author: Dr Naomi / 28 Oct 2015

TREATING EXCESSIVE SWEATING WITH INJECTIONS
Excessive sweating, also called hyperhidrosis, is a common problem, which is quite disturbing to the sufferer. Those affected complain that they can only wear white or black clothes, and that it is really embarrassing.
Sometimes excessive sweating is genetic, and will run in a family.
Small injections with a very fine needle are used to resolve the excessive sweating problem

The consultation for excessive sweating assessment

History-taking  is very important in the treatment of excessive sweating. The following should be explored:

  • Is there a genetic component? 
  • ie are there others in the family who have excessive sweating?
  • Has the patient had treatment before?
  • Were they happy with treatment every time?
  • Did the effect of toxin injections last well?
  • Which area came back first?
  • Which areas of the body are affected by excessive sweating?
  • How is the patient’s metabolism? Do they exercise? 
  • Are they very muscular? 
  • Do they have trouble putting on or losing weight?
  • Are there any other areas of excessive sweating, including back, hands or feet.
    Have they every had any complications with injections for excessive sweating before, perceived increase in sweating elsewhere.

The examination
The doctor may decide to do an iodine starch test, where she will first  wipe the affected area with betadine wipes and then pour some cornstarch powder in the area. This will show exactly where the sweating problem exists.

Choosing the dose for excessive sweating
The doctor will assess the sweating and decide on the best dose after taking a history and examining the patient. In particular discussing with the patient re their budget.
There are a couple of options for dosage for excessive sweating. A larger dose may be used, which costs about $990 or a smaller dose may be used (cost approx $680) the difference will be the longevity that is obtained.
If the patient has a history of poor longevity, or needing high doses or wanting maximal effect, then a higher dose may be suggested
If a patient has a history of complications with muscle relaxing injections, or if their budget is small or if they want a more subtle result, then a smaller dose might be chosen.

Pain relief during treatment
A numbing cream (eg EMLA or LMX ) may be applied to the area prior to the treatment (45 minutes prior is ideal) Glad wrap may be used over the numbing cream to increase its effect.
Ice is always used to decrease pain and to reduce the risk of bruising.
Patients may use Penthrox for excessive sweating treatments
Nitrous oxide (Happy Gas) is available for use for injections for excessive sweating

What happens during the excessive underam sweating treatment itself?
EMLA can be applied to the underarm and covered with gladwrap for 45 mins prior to the procedure.The area will be cleaned with alcohol. Ice will be applied to the area briefly before treatment. The doctor will inject multiple sites in the affected area. Then pressure with gauze will be applied. The procedure itself takes less than 20 minutes.

How do I look afterwards?
Sometimes there is nothing to see. Sometimes there can be redness, small lumps, which can look like mild acne and usually resolve quite quickly.

Typical problems which can occur:
In general, treatment of  excessive sweating is very low risk.The problems which occur depend on the area of the body that is injected.Headache happens in around 10% of new users.Bruising occurs in a significant number of cases.Asymmetry: One side may be better treated than the other, this is usually because the patient has asymmetrical sweating to start with..

Infection is a very rare complication, but always a possibility when the needle goes into the skin.
There is a low risk of muscle strength being affected in the area of injection. There is a possibility of a perceived increase in sweating in other areas of the body

Who is unsuitable for treatment of excessive sweating?
Most people with a excessive sweating are suitable for this treatment

Instructions for care afterward
No deodorant for 4 hours for underarm treatment
No massage that day
No heavy exercise that day
No lying down for 4 hours

What to expect after excessive sweating of underarms treatment?
The effect of the B or D will not start to occur for 2-8 days.
The maximal effect of the drug will be at 3-4 weeks, so a review should be booked if required  for 3 weeks. If at that time, further treatment is necessary, it should be performed. The starch iodine test may be necessary

What if I get asymmetry of sweating or I am still sweating at some time before the 3 week point? Do I call the doctor?
No. No need to call the doctor. Sometimes asymmetry will occur because one side just comes on quicker than the other. Usually it will right itself by the time of the review appointment. If it doesn’t, then it can be treated at the review appointment. There is no point in coming in early for treatment of asymmetry.

What do I do if at 3 weeks post treatment one side is better treated than the other?
This is not uncommon, at your 3 week review appointment, further treatment may be administered.

How long will the treatment last?
The answer to this is very individual and depends on the patient’s metabolism, the dose, the placement etc.
At a higher dose, about 30% of patients will get 1 year out of the treatment.
The rest will probably require retreatment at 8 months.
At a smaller dose, retreatment may be required several months earlier than above

When should I have my next treatment for excessive sweating
When the sweating recurs or at 1 year, whichever occurs first

How much does it cost for excessive sweating

For one area eg the underarms $680-$990

hands $990

feet $990

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