Excessive sweating treatments

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Hyperhydrosis is a common condition which usually starts in early adulthood. It presents as excessive sweating in areas such as the palms, soles, underarms and face.  The severity of hyperhydrosis is variable, ranging from a slight increase in sweating thru to profound sweating of the areas described above. With primary hyperhydrosis ( the most common type), there is no reason for excessive sweating, however in some patients a family history may be present. It is usually worse during the day, and situations such as stress and anxiety may increase the severity.  Secondary hyperhydrosis is uncommon, however diseases such as diabetes and thyroid disease will need to be excuded with simple medical tests. Additionally medication such as antidepressives and pseudoephidrine may be a cause of hyperhydrosis.

For more information on Hyperhydrosis click here.

Treatment thresholds are variable and individualised. The most important question to ask is ‘ Does hyperhydrosis have a significant IMPACT on my life?”  If the answer is ‘Yes” then treatment should be sought. Hyperhydrosis may play a significant impact on one’s social and work situations and commonly may cause emabrashment in social situations, impair relationships, decrease productivity at work, and even stop sufferers from wearing their favourite article of clothing!

For a self assessment guide and questionaire on the impact of excessive sweating click here.

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There are 5 main ways to treat hyperhydrosis/ excessive sweating- 1. Over the counter preperations of antipresperants 2. Prescription creams and tablets 3. BTX injections 4. Iontophoresis and 5. Surgical treatments

The first step in treatment of hyperhydrosis is with over the counter anti-persperants- you can obtain Driclor thru your pharmacist.  Antiperspirants work by blocking the sweat gland itself.  Skin irritation with Driclor may limit its effectiveness, however steps maybe taken to limit this.

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• Aim for application at night, wash off in the morning.
• Apply to dry skin (eg after a shower). Use a hair dryer in the ‘cool setting ‘to dissipate  moisture. It is very important to apply to DRY skin as this will minimise irritation. Apply Driclor to the area. Aim to use nightly until sweating decreases, then decrease application.
• If skin irritation develops- ensure that application technique is done correctly. You can also decrease frequency of application- eg. Every second night.  If skin irritation is still seen, a brief application of a topical corticosteroid may help. 1% Hydrocortisone cream maybe used in the morning. This can be obtained from your chemist.  If skin irritation is severe, then a prescription of Betnovate ½ cream from your local GP may assist. Do NOT use more than 2-3 times a week.
• Driclor maybe a very simple solution for your hyperhydrosis, and can be safely  used long term.

Tablets that can be used are in a class known as anti-cholinergics- these tablets do not act at the sweat gland level, but within the central nervous system. These are prescription only medication which can be presribed by your local doctor prior to visiting a specialist. Side effects are commonly seen, including dry mouth, and sedation. Your prescribiing doctor will discuss more on these tablets.

Prescription creams can also be compounded. These creams are essentially anti-cholinerics added to a cream base,  prescription is via a specialist dermatologist.  Creams can be effective in upto 40-50% of patients, however absorption may occur, leading to side effects seen in tablets.

BTX/anti –wrinkle injections is widely accepted as the treatment of choice for underarm sweating not responsive to antipresperatants. It has received FDA approval for the treatment of Hyperhydrosis and has been widely used in both Australia and the United States for over a decade.

More information on the use of BTX for Hyperhydrosis

BTX treatment for hyperhydrosis

This method has been widely accepted as the treatment of choice in areas such as underarm areas and the face.  Botulinum molecules work by temporary blocking the chemical signals to the nerves that stimulates the sweat glands. This procedure is virtually painless and lasts upto 6-9 months.  BTX has an excellent safety record with proven efficacy.

BTX can also be performed on the hands and feet, as well as the face and scalp.

How is the treatment perfomed?

The procedure can be performed on the same day as the consultation, and takes between 10-15 minutes to complete. An anesthethic cream is then applied to the area to be treated and left on for 20 minutes. The use of this cream makes the procedure virtually painless. The area is then injected with BTX via a very fine needle.  Approximately 15 sites are injected into each underarm area.

How long does BTX last for?

You will start to notice a reduction in sweating within 2 weeks of treatment. Maximal reduction occurs 2-4 weeks post treatment, and typically lasts 6-8 months.

What treatments should I try BEFORE BTX injections?

The absolute first step is the correct application of Driclor to the areas involved.  Refer to the application guide above for correct usage. 

In some situations, tablets may act as adjunctiive treatments. You will require a prescription from a medical practitioner. Remember these tablets have side effects – consult a health professional before use.

General guide to usage.  Propanthelene Bromide 15 mg, initially take one tablet at night - if tolerated one can increase to one tablet three times a day. (Note, this is a prescription medication and you should discuss the possible side effects with your prescribing doctor and your pharmacist. )

Any secondary causes of hyperhydrosis may need to be considered – a medical practitioner may assist .If your hyperhydrosis still persists, then BTX maybe a treatment option, and a referral  to see one of the procedual  dermatologist maybe of value.

Things to consider BEFORE consulting a Specialist Dermatologist for Hyperhydrosis. Click here

Iontophoresis  involves sending a small electrical current to the surface of the affected area while it is submerged in water. Iontophoresis  is thought to be first line treatment of the hands and feet ( where irritation secondary to Driclor can be a problem), however it can also be used for sweating of the armpits. In general, treatments must be repeated several  times per week. The procedure can be done at home using a home device. Cost of iontophoresis units vary between 600-950 Dollars.

More on iontophoresis

A variety of surgical approaches have been used to treat severe underarm sweating, but they are usually reserved for the most extreme cases that do not respond to other treatments.Endoscopic thoracic sympathectomy involves surgical interuption of the nerves signals between the spinal column and the sweat glands in the affected area.  This procedure is conducted in an operating theatre by a specialist Thoracic surgeon or a neurosurgeon.

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Hyperhydrosis can also affect the scalp, forehead, and nose areas, and, like hyperhydrosis of the armpits and other areas, the impact on the patient can be significant. Fortunately, treatments such as BTX have proven to be ultra successful in treating excessive sweating in these areas. ( The bonus is that less wrinkles are also noted in treated areas!)

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The success of natural remedies are very limited, however there have been a few reports on the use of sage tea, camomile and St John’s wort  for the treatment of hyperhydrosis.

For a summary of treatments and more information on Excessive Sweating visit www.sweathelp.org

BTX treatments are NOT claimable by Medicare/ Private Health Insurance

Dermatologist are medical doctors who specialize in dealing with skin conditions – including sweat glands.  As specialist, a referral is advisable from your GP, this enables patients to claim a percentage of the consultation fee from Medicare.

Call reception directly on (07) 3871 3437 to book an appointment or discuss the referral process.

Enquire about excessive sweating treatments

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Dr Davin S. Lim, Consultant Dermatologist

Hyperhydrosis is a common disorder thought the impact on the patient is often underestimated. The majority of cases can be managed with over the counter antipersprants. The correct use of Driclor is the absolute first step prior to any other treatments. In the event that sweating still persist despite optimal compliance and technique, BTX proves to be a safe and very effective treatmment.  This technique is best suited for underarm sweating and the results are often seen upto 6 months post treatment. I always use a local anaesthetic cream, which makes the procedure virtually painless.

"No more wet patches  under my armpits- I can wear what I want, when I want."  K. Mc Carthy , 27

"Treatment has given me a new lease on life....should have done this years ago. Well worth it."  M. Keogh  25

"Treatment with Botox was virtually painless. Saved heaps on dry cleaning my uniforms, but the increase in my confidence….priceless."  Karen L, Police Officer. 32