Thursday, September 9, 2010

Using Botox for Hyperhidrosis

 Updated 3/2017-- all links (except to my own posts) removed as many are no longer active and it was easier than checking each one.

A few months ago a friend asked me about using Botox for her axillary hyperhidrois.  I had not ventured into this use of Botox (no patients referred or ask for it), but have been intrigued by it.  
A few weeks after our discussion which included me suggesting she ask her Dermatologist about the treatment as I felt this would be easier for her to get her insurance to cover the cost, I had the opportunity to use some “leftover” Botox on her.  This meant she would only get approximately half the suggested units, but she jumped at it.
Before treatment in addition to using antiperspirant, she would wear a T-shirt under her scrub top.  Often she would add protective “pads” to prevent ruining her good clothing.  Since she has been able to forgo the “pads” and the t-shirts.   It hasn’t been long enough to know if the reduced dose will reduce the longevity of the treatment.
Botulinum toxin (Botox) treatment temporarily blocks the nerves that trigger the sweat glands. The FDA approved Botox for axillary (underarm) hyperhidrosis in 2004.
The recommended dosage of Botox solution is 50 Units per axilla per treatment.  This is divided into injects approximately 1.5 – 2 cm apart.  (photo credit)
The pain my friend experienced seemed to be minimal, but topical creams could be used.
Improvements in sweating are typically seen within two to four days. The benefit usually lasts four to six months. Then, the treatment needs to be repeated.
Botox Website:  Severe Underarm Sweating
Medscape has a video by Marina Peredo, MD on the Treatment of Hyperhidrosis With Botox
Dr. William Hall has a nice Youtube video:  BOTOX for Excessive Sweating/Hyperhidrosis Procedure.
Hyperhidrosis: A Review of Current Management; Atkins, Joanne L.; Butler, Peter E. M.; Plastic & Reconstructive Surgery. 110(1):222-228, July 2002
Use of A Grid To Simplify Botulinum Toxin Injection for Axillary Hyperhidrosis; Lam, David G. K.; Choudhary, S.; Plastic & Reconstructive Surgery. 112(6):1741-1742, November 2003.
Use of a Grid to Simplify Botulinum Toxin Injection for Axillary Hyperhidrosis; Kavanagh, Gina M.; Plastic & Reconstructive Surgery. 117(1):317, January 2006.
Botulinum Toxin A for Axillary Hyperhidrosis (Excessive Sweating); Marc Heckmann, M.D., Andrés O. Ceballos-Baumann, M.D., and Gerd Plewig, M.D.; N Engl J Med 2001; 344:488-493

1 comment:

StorytellERdoc said...

You are a good friend, Ramona! LOL And I found this intriguing, since we don't do anything like this in the ER. Thanks...and hope this finds you well, friend.