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Sweat Much?

Excessive sweatingSummer has been well and truly upon us the last few weeks. It is interesting how sunlight lightens the mood. It is also amazing the effect that it has on self image.

The minute that the sun appears we start to think about our appearance more. We’ve seen a big jump in the number of treatments at our Bristol clinic in the last 6 weeks.

This is also the time of the year that patients start to think more about sweating. Not a nice topic I agree but one that is more commonly suffered than discussed.

Axillary hyperhydrosis is a condition where there is excessive sweating in the underarm area. Typically there is no underlying medical condition and the patient is otherwise well. Generalised sweating, particularly at night, weight loss or associated excessive fatigue warrant a trip to see your gp for a check up.

The classic case is the black shirt or blouse wearing, long sufferer that changes their top a few times a day. The poor soul has tried every antiperspirant known to mankind. They’ve even had a go with “Driclor” which may work initially but eventually produces a wicked irritant dermatitis and a red, dry, painful, sometimes weeping armpit. Nice. It’s also a very popular “celeb”procedure.

When I was a medical student back in the 90s the only cure was the rather scary sounding, endoscopic, transthoracic sympathectomy. This surgical operation involved a general anaesthetic, followed by collapsing your lung and then essentially burning the nerve supply to your sweat glands. It worked but it was fairly invasive to say the least! It also stops sweating in the whole arm and most patients experience increased sweating elsewhere.

Botox pretty much revolutionised the treatment of excessive sweating in the underarms. The drug works by temporarily blocking the activity of the nerves in the treated area. When we use it for cosmetic purposes we place it within the muscles of the face, thus blocking the action of the muscle, softening the wrinkled skin overlying.

When we are treating excessive sweating we place the drug more superficially, into the skin. Here Botox blocks the nerve supply to the sweat glands. It reduces sweating usually by 3 to 4 times. Many previously socially embarrassed patients can stop using antiperspirant, or at least wear colluded clothing!

The treatment is a simple procedure. The area to be treated is demarcated by using iodine and cornflour to show up the sweat glands. The area is circled and marked out into a grid pattern. Between 16 and 20 injections are placed in each side. This sounds a lot but the needle is TINY and even my male patients tend to find it easily tolerable! Effects usually last 6 months and tend to improve with repeated treatments. Occasionally a top up procedure is required after a number of weeks.

So if you’re a sweaty mess, it may be that we can help you

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