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Injections for Facial Sweating

Author: Dr Naomi / 28 Oct 2015

TREATING EXCESSIVE FACIAL SWEATING WITH INJECTIONS
Excessive sweating of the face, is a common problem, which is quite disturbing to the sufferer. Those affected complain 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?
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, underarms or feet.
Have they every had any complications with injections for excessive sweating before eg eyelid/eyebrow droop, muscle weakness or perceived increase in sweating elsewhere.

What is the patient’s occupation and hobbies? The potential complication of muscle weakness or loss of facial expression needs to be discussed in relation to these facts

Which areas of the face are most affected with the sweating
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 on the face
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 of the face. A larger dose may be used, which costs about $990 or a smaller dose may be used (cost approx $680)
If the patient has a history of poor longevity, or needing high doses or wanting maximal effect, or the surface area is larger than average, 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 of facial sweating

A numbing cream (eg EMLA or LMX ) will 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 of the feet
What happens during the excessive facial sweating treatment itself?
EMLA can be applied to the face 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 on the face. 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.
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 risk of muscle weakness in the face causing eyebrow droop / eyelid droop or smiling abnormalities

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 heavy exercise that day
What to expect after excessive sweating of feet 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?
At your 3 week review appointment, this will be investigated and 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.
4 months would be a typical time to retreat the area
When should I have my next treatment for excessive sweating
When the sweating recurs or at 4 months, whichever occurs first
How much does it cost for excessive sweating of the feet

$680-$990

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