Hyperhidrosis (Axillae,Palms and Soles): Hyperhidrosis - excessive sweating is a condition that creates a challenge for patients. Hyperhidrosis can cause serious social, emotional and occupational problems. Patients with axillary hyperhidrosis can soak through their clothes in minutes and resort to pads, shields and frequent changes of clothing to cope with the condition. Clothes are quickly stained and ruined, plus thousands of dollars are spent on replacement of clothing and dry cleaning.

PAST TREATMENT OPTIONS:

A) Medical

• antiperspirants (which include all forms of aluminum chloride plus aluminum hexachlorhydrate - Drysol)
• Iontophoresis (this has proven to be of no value)
• Oral anticholinergic drugs (too many side effects to be of value)

B) Surgical

• Axillary sudarectomy (excision of axillary sweat units)
• Thoracic surgical sympathectomy (potential serious complications)
• Liposuction cannulae - (separating sweat units from deep tissues)

All of the traditional dermatological treatments and surgical approaches have been disappointing and frustrating for patients with significant hyperhidrosis.

CURRENT TREATMENTS:

• Laser hair removal for unwanted axillary hair has, by serendipitous experience, shown to significantly reduce sweating as a secondary event. This may prove to be a long term benefit.
• Botox is a wonderful, relatively new, simple treatment option for hyperhidrosis.

TREATMENT:

A) Axillary hyperhidrosis

• Prescription to purchase Botox, bring to the Remington Laser Centre for injections.
• Emla-Max - an anesthetic cream; bring to the centre for topical application 15 - 30 minutes prior to treatment.
• Treatment technique: a very tiny needle is used in the numbed sweat zone. Some patients require up to 75 or 100 units per axilla to create the results they are looking for.
• Post Treatment Guidelines: Continue your regular lifestyle including bathing, showering and swimming.

Side Effects:

• With Emla-Max treatment is essentially painless, no other sedations are required.
• Rarely bruising can occur
• Muscle weakness of the arm, forearm and hand is a rare event with the smaller doses we now use.
• Repeat Treatments: It takes 10 days to 2 weeks for Botox to create positive results. Usually repeat treatments are not done for 6-12 months.

B) Palm and Sole Hyperhidrosis

• Prescription for Botox - bring to the Remington Laser Centre for treatments.
• Prescription for topical Emla-Max, a topical anesthetic - bring to the Remington Laser Centre to be applied 15-20 minutes before treatment.
• Day of your treatment a prescription of Percocet and Valium will be used 1 hour before your treatment session.

A driver to take you home is essential because of the pre-op sedation you are not allowed to drive after the treatment.

Treatment technique: a very tiny needle, 50 units per palm. Treatment is combined with ice.

Post Treatment Guidelines:

• Continue regular activities including showering, washing, swimming and exercise.
• Using the hands is a positive influence as moving the small muscles of the hands helps to spread the Botox into the tissues.

Side Effects:

• This can be a painful treatment without the above precautions including the Emla-Max and Pre-op Sedation (Valium, Percocet), Ice and the tiny 31-32 gage needles.
• Post treatment burning and tingling sensation is uncommon but if present will disappear very quickly (within minutes).
• Bruising is uncommon and always disappears spontaneously.
• Repeat Treatments: It takes 10 days to 2 weeks for Botox to create positive results. Repeat treatments are required at 6-12 months. The timing of the repeat treatments depends on the person.