Botox:

I have personally found Botox to be the answer to my excessive sweating. It has been used for the past 14 years to relax eye muscles and neck spasms. More recently it has received much press as a way to smooth out wrinkles of the face and forehead. In the past 3 years it has been shown to work extremely well to block nerve transmission to the sweat glands. This works under the arms, for the hands and feet as well as the forehead.

The areas are tested before injection using the Minor starch-iodine test whereby the specific
areas of sweating are identified and only those areas are treated. A Betadyne solution is painted on the skin and cornstarch is applied over it. The areas that have perspiration turn the cornstarch dark blue. The injections are made with the thinnest needle available. The injections under the arm require no anesthesia and with the syringes being changed frequently, cause minor stinging.

There are approximately 15-20 injections per side, usually using 50 Units of Botox per side. For injections of the hands and feet, twice the amount of Botox needs to be utilized due to the larger surface area that needs to be treated and the less diffuse spread of the Botox. Since 40-50 injections need to be given per side (100 Units per side), we use nerve blocks to the hands and feet to prevent any discomfort. These are easily done and make a great difference to the patient.

The length of time that the Botox works depends on the site. For axillary sweating, the mean time of relief is about 7 months with some patients getting up to a year of being sweat free. The hands and feet are sweat free for a mean of 4 months with some patients being sweat free for up to a year.