Excess Sweating New York City
Under normal circumstances, sweating is a necessary bodily function whose primary purpose is to regulate and maintain body temperature. Perspiring sweat that is produced by minute glands all over the body to release water, wet the skin and through evaporation, cool the body. Hyperhidrosis, or excessive sweating, is an abnormal condition which affects 3%-4% both men and women and has no race nor ethnic prevalence. It is most common in adults and adolescence and can be prevalent in families. Although it can occur in many different areas, it is particularly troublesome in the axillae [armpits]. It can affect the palms of the hands, soles of the feet and genital area as well. This condition is very stressful to those who suffer from it – it wets, stains and ruins clothing and is a constant source of embarrassment both because of the look as well as the odor it may produce, caused by bacteria. It affects individuals in their personal, social and professional lives compromising their day by day and hour by hour existence. To make matters worse, the stress and apprehension of this profuse sweating increases anxiety and worry causing more nervous sweating.
There are conditions such as menopause which also cause excessive sweating which is different from primary hyperhidrosis even though the consequences are the same.
Other than the use of strong antiperspirants, medications to reduce anxiety and relaxation therapies to calm and control nervous perspiration, the options for treatment are basically two. The simplest treatment is with substances which turn off the sweat gland function –that is with the use of Dysport or Botox. Both these substances are composed of denatured botulinum toxin which have a direct effect on the nerves that innervate the sweat glands and stimulate secretion. By turning off the stimulation, the glands do not secrete. These substances are given by injection and with topical anesthesia to reduce needle pinches. They are remarkable effective in most patients and can reduce perspiration in affected areas by 90-100% within 4-7 days. Treatment effects usually last 3-4 months and sometimes, 6 months. There is a gradual return as the medication wears off. Patients often plan treatment sessions in anticipation of special events such as weddings as well as before summer when perspiration naturally increases. There are minimal if any side effects to this treatment other than the need to return for follow up treatments. If fact, when hyperhidrosis is generated by anxiety and “nervous” sweating, one or two treatments with Dysport or Botox can set a new tone by reducing or eliminating the anticipation of excess sweating. By “unloading” the anticipation and fear of sweating, patients often continue through life with relief.
A second treatment for sweating, especially in the armpits is surgical removal of the sweat glands. This is done under sedation and local anesthesia and is effective because of the removal of the glands. It is done on an ambulatory basis, associated with moderate pain and discomfort and does require a 3-5 day recuperation. It can reduce sweating in the armpits by 80%-95%. Dr. Simone will discuss the best approach for you and if surgery is the more appropriate option, review risks, complications and anticipated results. Prior to a surgical approach, it may be best if a patient tries a course of Botox or Dysport injection to see if that is a better, non-surgical alternative.