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Excessive Sweating (Hyperhidrosis)

Sweaty armpits are not pleasant for anyone!

The medical term for the armpit is the axilla. Excessive axillary sweating (or axillary hyperhidrosis!) can make anyone’s life a misery. There are obviously antiperspirant sprays and in particular Aluminium Chloride based preparations (Anhydrol Forte, Driclor and ZeaSORB). Hand and foot sweating can be helped by Glycpyrronium bromide 0.05% solution (Robinul). They are applied 2-3 times a week at night and washed off in the morning to avoid damage to clothes. Application can be very effective especially for underarm sweating. However they can cause the skin to become irritated over time.

There are treatments that can be taken by mouth:

Antimuscarinic drugs – these are tablets or capsules that reduce the activity of the nerves supplying the sweat glands. They do affect the body’s entire nervous system and can cause side effects like dry mouth, drowsiness and constipation.

Beta-blocker drugs also act on the nervous system but their side effects are usually less troublesome. They may help if sweating is made worse by stress and feelings of anxiety. They are not suitable for everyone because some people with certain medical conditions cannot take them.

Anxiolytic drugs (tranquillisers) may be helpful if anxiety is found to be a problem but there are side effects and they are often not recommended long term.

However, there is an extremely effective treatment for armpit sweating ….. Botox.

The axilla has a multitude of sweat glands and each gland has a tiny muscle that extrudes the sweat (sebum) onto the skin.

Botox can paralyse these tiny muscles and can give months of very effective abolition of sweating.

The procedure takes about 30 minutes:

Firstly you need to be happy with all the information about botox itself – its side effects and risks. The axilla is a very forgiving place to inject and there are very few complications associated with this area. There are no cosmetic blunders that can occur here.

The physician will firstly observe the area to see where the sweating occurs. This is usually quite well linked to the hair-bearing areas. If there is any doubt, a iodine starch test can be performed which clearly stains the sweat producing areas.

A local anaesthetic and ice are then applied to the area. It is a sensitive area and this part is, in truth, a little uncomfortable – but this procedure is so effective that it is usually well worth it.

Each armpit will receive about 4 local anaesthetic injections and once it is all numbed up – the procedure can begin.

The physician will draw a grid of 1cm squares over the sweaty areas and will place a small volume of botox in each square. On average this will mean about 20 tiny injections in each axilla (a total of 50 units each side) – and that’s it.

This will not abolish sweating completely, but you should notice a dramatic reduction. Many patients don’t even use deodorant at all.

The effect should last about 6 months, but many report that they only ever need the procedure once per year.