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Are botox injections helpful in treating excessive sweating?

Q: I suffer from excessive sweating. I have read that Botox injections are derived from the bacterium clostridium botulinum. It blocks the nerves that trigger the sweat glands. Despite the recent FDA approval, botox injections have been used by dermatologists for about 10 years, not only to treat underarm hyperhidrosis, but also that of the palms, soles, and face. Can you offer your suggestion on this? I have an important function to attend. How many days before the function should I use it?

A:Excessive sweating or hyperhidrosis, is caused by stimulation of the sweat glands by nerve endings which descend from higher centres in the brain. These nerves respond to emotional stresses; like intimate social situations, public speaking, physical stresses, and increased body temperature that comes with exercise or hot humid weather. Treatment includes: 1. Deodorants and antiperspirants Aluminum chloride hexahydrate and salts are used in topical antiperspirant sticks, creams, lotions and solutions. These prevent sweating by clogging the sweat ducts in the skin. These products can be irritating with continued use and are largely ineffective in people with excessive sweating. 2. Anticholinergic drugs and tranquilisers Oral medications currently used often provide relief but can cause dry mouth and blurry vision. Tranquilisers may minimize ones anxiety, but do little to diminish actual sweating. 3. Tap Water Iontophoresis Battery-powered electrical devices that use, water consist of a moist pad and a prickly electrical current held against skin for several hours. Although they decrease sweating in some people, they are time consuming and they need to be repeated on a daily or a weekly basis. Iontophoresis is mildly effective for severe cases. 4. Surgery: Not desireble except in extreme cases. 5. Botox: can prevent sweating for months by blocking the release of the neurotransmitter, i.e., acetylcholine, from the nerve endings, that causes the glands to produce sweat. Fifteen to twenty drops of Botox are injected via a very small needle into the hair-bearing skin of each underarm. Normal activity can be immediately resumed, while heavy exercise should be avoided for several hours. Most patients will obtain the benefit of dryness with one treatment of Botox for six to ten months. Complications from injection into the axillary skin include tiny bruises which fade in a few days, and small persistent areas of sweating that may need a second treatment. There is no risk of numbness or permanent change in the axillary skin, and the risk of temporary muscle weakness is remote.

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