A New Wrinkle in Fight Against Perspiration
Botox paralyzes sweat glands, helping those who perspire excessively
SATURDAY, June 2, 2001 (HealthDayNews) -- A treatment commonly used to smooth away wrinkles is now helping with yet another of the body's unwelcome indignities -- profuse sweating.
Tiny injections of botulinum toxin type A can significantly reduce sweating by paralyzing sweat glands when injected into the armpits, according to a recent study at the University of Munich in Germany.
The toxin, sold commercially as Botox, is often used by doctors to reduce eyebrow lines and other facial lines and wrinkles. While its use to treat profuse sweating is far more limited in the United States, that could change quickly, based on the results of the German study.
Treating 146 people with hyperhidrosis -- a condition that causes excessive sweating -- the German researchers found that two weeks after injecting Botox into patients' armpits, their sweating had been reduced by 85 percent.
And what had it been to start with? As many as four cups of sweat in eight hours, say the researchers, demonstrating why patients with hyperhidrosis are desperate to find a treatment that works.
"These patients don't just sweat, they drip and have to change their clothes six times a day," explains Dr. Dan Berg, director of dermatologic surgery at the University of Washington Medical Center in Seattle. "Their palms are sweaty and they can't shake hands with anyone and are embarrassed in social situations."
The disorder, whose cause is unknown, is believed to affect as many as 2 million Americans.
The toxin's effects are temporary, however. The patients in the German study began sweating more heavily after two weeks. But even after 26 weeks, they were perspiring, on average, less than half of what they had been before the treatments.
Results of the study were published in a recent issue of The New England Journal of Medicine.
No need for fear
Despite the increasing use of Botox, some people still fear injecting something into their body that is associated with botulism -- a potentially fatal form of food poisoning, says Dr. Robert Singer, a La Jolla, Calif., plastic surgeon.
"It's a normal response to be concerned. But this is an extremely low dosage that does not produce the negative side effects that one might think of," Singer says. "In fact, there are many, many things used medically that, if used in higher dosages, can be toxic, but in the right formulation or minute amounts are very effective and safe."
"Botox is injected in a very dilute form into a localized area, so it doesn't affect the body elsewhere. It only affects the [area] it's injected into, he adds.
The drug reduces such wrinkles as crow's feet, frown lines and furled eyebrows by interfering with the transmission of the nerve impulses that make those muscles contract, says Singer.
Berg says Botox controls sweating in much the same way, but with a few twists. "For one thing, more Botox is generally required for the sweating than for wrinkles."
"It works under the same mechanism -- it still inhibits the function of the nerve supply, but it's the supply to the sweat glands," he says.
Botox treatments for hyperhidrosis aren't for the needle-phobic. They involve up to 20 injections under each armpit. But doctors say that because the needles are so thin and the injections so shallow, the procedures aren't all that painful.
"It's not super pleasant, but most patients don't have a problem with it," Berg says. "In the palms and the soles, which are the other places it has been used, it can be more of a problem, but not typically in the armpits."
The treatments can cost $1,000 or more and last for anywhere between five and 10 months. They are typically not covered by health insurance plans.
'It has changed my life'
But the cost and momentary needle stings are well worth the benefits for Jaime West, a 27-year-old Seattle marketing manager who has suffered from hyperhidrosis for 10 years.
"This has really changed my life. It's quick, it's relatively easy and the effects are amazing," she says.
West says that before trying Botox, she had struggled with various treatments to little or no avail. They included topical medications that caused rashes and burning sensations.
She read about the use of Botox for hyperhidrosis on the Internet, but was unable to find a doctor who offered the treatment until she contacted the University of Washington, which put her in touch with Berg.
Upon receiving the injections, the results were dramatic, West says.
"The treatment started working probably within a day and it was just incredible. Certainly you still perspire normally, but it's able to be controlled with antiperspirant just like a 'normal' person."
West says she'd recommend the treatment to anyone with the condition.
"It makes all the difference in the world. I will continue going to get this treatment unless some miracle happens and I don't need to have it anymore," she says.
Apparently, West is not alone. According to the German study, 98 percent of the participants said they'd recommend the therapy to others.
What To Do
Read more about hyperhidrosis and the use of Botox at The Society of Thoracic Surgeons.
You can read about other uses of Botox in this American Academy of Dermatology article.