Late July and August are sometimes known as the ‘Dog Days of Summer.’ It’s the hottest time of the year. We may find ourselves sweating more than usual during these months, but for those who suffer from excessive sweating (hyperhidrosis), dealing with sweat is a year-round part of life. Botox is one treatment option for excessive sweating that you may not be familiar with. In this blog, we talked with Dr. Jennifer Holman of the Center for Aesthetic and Laser Medicine in Tyler, TX., about treating patients with Botox for sweating during the dog days of summer and year-round. Keep reading to learn more.
What is Botox?
Botox is a medical treatment that uses a controlled dose of the botulinum toxin. The potentially beneficial effects of this neurotoxic protein were discovered through the evaluation of individuals who had high levels of clostridium botulinum bacteria in their systems. These people were usually suffering from food poisoning, but medical professionals noticed that the bacteria seemed to also be causing muscle paralysis.
Later, it was discovered that botulinum toxin actually prevented the release of certain neurotransmitters that tell specific muscles to move. It took many years of additional research, but today, controlled injections of the botulinum toxin that gives Botox its name can be used for a number of medical and cosmetic purposes. You may already be familiar with the use of Botox injections to limit muscle movements in the face and reduce the appearance of fine lines and wrinkles. In addition to this common practice, Botox has also been used for a number of therapeutic purposes, including migraine relief, treatment for muscle spasms, and prevention of excessive sweating.
How Does Botox Help with Sweating?
Like other uses of Botox, its application for those with hyperhidrosis involves targeting the specific set of neurotransmitters that are activating sweat glands. This means that Botox only reduces sweating in the specific injection area. At this time, Botox injections are only FDA-approved for use in treating axillary hyperhidrosis, or excessive underarm sweating.
However, it has been approved for “off-label” use in other targeted areas like the hands and feet if certain criteria are met. Off-label doesn’t necessarily mean anything nefarious. It simply indicates that a specific treatment hasn’t completed the same amount of testing as FDA-approved uses for the same medication, but indications suggest it will be effective. In the case of off-label uses of Botox for sweating, there are numerous completed and current studies to support these treatment options. A Canadian study first published in 2009 indicates an 80 to 90% rate of success when using Botox for palmar hyperhidrosis (sweaty palms). A similar study showed a reduction in forehead sweat in up to 75% of cases. Research into plantar hyperhidrosis (sweaty feet) also proved Botox to be effective, but patients experienced more discomfort from the injections themselves.
According to Dr. Holman, “Like any other condition, we start with simple solutions like prescription antiperspirants first before recommending Botox. For those who have hyperhidrosis that hasn’t been responsive to more conservative treatments, Botox can be a beneficial option. In many cases, the use of Botox allows us to improve a patient’s condition without the need for more invasive surgical interventions, which is great news for people struggling with excessive sweating.”
How is Botox for Sweating Administered?
Like other forms of Botox treatment, the controlled doses of botulinum toxin are injected directly into the area where you experienced excessive sweating. Injections are applied in a grid-like pattern to ensure the entire area is covered, but at a follow-up visit, we will reassess and administer additional injections as needed for full coverage. The small-gauge needle means most people are comfortable during injections, but for treatment of larger or more sensitive areas, we may also utilize numbing or anesthetic techniques.
How Often Will I Need Retreatment?
The specific neurotransmitters that control sweating in that part of the body are essentially frozen by the botulinum toxin. Like any frozen thing, they can thaw out. When this happens, you’ll need retreatment. In most cases, your dermatologist will work with you to set a retreatment plan in advance, so you don’t have to experience excessive sweating again. After Botox treatment takes effect, you may not experience any excessive sweating for anywhere from four to fourteen months or longer in some cases.
In order to better determine your specific response to the injections, we will schedule a second visit just a few weeks after your injections. This allows us to evaluate how well the injections are working, provide touch-ups for missed areas, and ensure you are not having any allergic or adverse health responses to the treatment. At this second visit, we are usually better able to determine how often it makes sense for you to receive retreatment. Typically, we recommend either biannual (twice a year) or quarterly (four times a year) retreatment visits.
How do I Know I’m a Good Candidate for this Treatment Option?
Botox injections are safe and minimally invasive procedures that can be recommended for almost any patient. Before we recommend Botox for sweating, we carefully review your health history and any current medications. Certain individuals are at greater risk for side effects from these treatments, so it’s important to be thorough in reporting all chronic health concerns and medications. If you take blood thinners, we may need to talk to your physician about suspending use of these medications for a few days before treatment. This helps to prevent bruising, and it may also be beneficial to avoid excessive bleeding at the injection site.
Cost is another factor that needs to be considered to determine whether or not you are a good candidate for this treatment. The price of injections will vary based on the dose, the number of injections needed, and a range of other factors. In some cases, medical insurance will cover the use of Botox for excessive sweating in the underarms only, since this is the use approved by the FDA. Before you begin your Botox treatment, talk to your doctor about the cost and ensure you are budgeting for this added expense.
What Should I Expect Before, During & After Botox Therapy?
Once you’ve been approved for Botox treatment, we’ll walk through a specific preparation, treatment, and aftercare plan. Below, we’ve outlined some of the basics.
Before Your Botox Treatment Visit
Before your treatment visit, you may need to cease taking blood thinners or other medications as recommended by your dermatologist and approved by your general practitioner and/or prescribing doctor. There are no restrictions on movement or activity necessary before or after injections, so you can plan to go right back to work, school, or your daily routine. We do ask that you not shave the area where we’ll be placing the injections for two to four days before treatment.
During Your Botox Treatment Visit
During your treatment visit, the dermatologist will use a small-gauge needle to inject the controlled levels of the neurotoxin just below the skin throughout the area where you experience excessive sweating. A grid pattern is used to ensure the whole area is covered evenly. To maintain your comfort, we may use one or more anesthetic techniques, but most people experience very little discomfort during the injections.
After Your Botox Treatment Visit
After your treatment visit, you’ll be given specific aftercare instructions that typically include applying ice to the treatment area if you notice any swelling. If you experience discomfort, please take over-the-counter pain relievers as directed. You may still notice sweating for up to two weeks after treatment, so we schedule a follow-up visit after this time period. If you are still experiencing excessive sweating at this point, we may recommend a different treatment approach.
You will be given a complete list of adverse effects to be aware of prior to your treatment. You should familiarize yourself with these symptoms and seek appropriate care as soon as possible if you experience any of them. Please call our office if you’re experiencing significant pain, swelling, or bruising around the injection site that does not improve after the first few days. If you notice a headache, body aches, or flu-like symptoms that clear up in a few days, please let us know about this at your appointment. If these flu-like symptoms worsen, you develop a fever, or you have difficulty breathing, visit your nearest urgent care provider. Severe side effects from treatments with Botox for sweating are rare.
Can U.S. Dermatology Partners Help with Botox for Hyperhidrosis?
At U.S. Dermatology Partners, we are dedicated to working with our patients to find the right treatment for their unique situations. That means we adopt and regularly utilize a wide range of technologies and treatment techniques to ensure all the latest and most effective therapeutic approaches are available. Our teams have used Botox to improve the appearance of skin for decades, and we’re happy to offer these treatments for clients with hyperhidrosis. When you’re ready to learn more about Botox for sweating, request an appointment with the team of experts at a U.S. Dermatology Partners location near you.
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