SAN FRANCISCO

22 Battery Street, Suite 905
San Francisco, CA 94111

415.956.8686

 

535 Miller Avenue
Mill Valley, CA 94941

415.383.5475

 

Hyperhidrosis Treatment
Hyperhidrosis Treatment

 

What causes underarm sweating?
Excessive sweating, or hyperhidrosis, is caused by stimulation of the sweat glands by nerve endings which descend from higher centers in the brain. These nerves respond to emotional stresses; like intimate social situations, public speaking, physical stresses, and increased body temperature that comes with exercise or hot humid weather.

photos of Dr. Binstock's patients**

Botox® Cosmetic Don't Sweat
"Starch Iodine Test" shows sweating diminsihed
Excessive Sweating Treatment Excessive Sweating Treatment

Most people with excessive sweating are bothered primarily when they are emotionally stressed, physically active, or over-heated. Botox® can prevent sweating for months by blocking the release of the neurotransmitter, i.e., acetylcholine, from the nerve endings, that causes the glands to produce sweat.

What are alternative treatments?
Deodorants and antiperspirants.
Aluminum chloride hexahydrate and salts are used in topical antiperspirant sticks, creams, lotions and solutions. These prevent sweating by clogging the sweat ducts in the skin. These products can be irritating with continued use and are largely ineffective in people with excessive sweating.

Anticholinergic drugs and tranquilizers.
Oral medications currently used often provide relief but can cause dry mouth and blurry vision. Tranquilizers may minimize one's anxiety, but do little to diminish actual sweating.

Tap Water Iontophoresis.
Battery-powered electrical devices that use water, consist of a moist pad and a prickly electrical current held against skin for several hours. Although they decrease sweating in some people, they are time consuming and they need to be repeated on a daily or a weekly basis. Iontophoresis is mildly effective for severe cases.

Surgery.
Surgical alternatives include cutting the sweat glands from the skin of the underarms, therein leaving visible scars and permanent numbness of the skin for decreased sweating. Neurosurgeons now use a fiberoptic surgical tube, to cut nerves in the neck which lead to the axillary sweat glands, i.e. endoscopic sympathectomy. This approach includes the risk of possible nerve damage to structures in the neck which can result in paralysis of the arm, loss of sensation, and permanent dilation of the pupil of the eye. Cosmetic surgeons and dermatologists have attempted to scrape the underside of the axillary skin with liposuction cannulas to remove sweat glands and the results had been mixed.

How is Botox® given?
Fifteen to twenty drops of Botox® are injected via a very small needle into the hair-bearing skin of each underarm. Normal activity can be immediately resumed, while heavy exercise should be avoided for several hours.

When will Botox® take effect?
Underarm sweating will be decreased by 90% within 48 hours and full effect will be seen within one week. There may be simultaneous disappearance of odor associated with decreased sweating, but this is not consistent.

How long does Botox® last?
Most patients will obtain the benefit of dryness with one treatment of Botox® for six to ten months.

What are the risks and complications?
Complications from injection into the axillary skin include tiny bruises which fade in a few days, and small persistent areas of sweating that may need a second treatment. There is no risk of numbness or permanent change in the axillary skin, and the risk of temporary muscle weakness is remote.

Who are good candidates for Botox® Don't Sweat?

  • Anyone with an increased or problem of underarm sweating.
  • Anyone who worries about sweating through their clothes.
  • Anyone who would like to wear fine fabrics, sleeveless shirts and blouses, or who would like to take their jacket off.
  • Anyone working in close contact with others such as hairstylists, nurses, physicians, dentists, hygienists, and flight attendants.
  • Anyone working in hot conditions, such as models, television personalities and chefs.
  • Anyone making public presentations, including: executives, attorneys, and salesmen.

Botox® Don't Sweat is the answer for problem sweating!
If you are interested in learning more about Botox® Don't Sweat, please contact our office at (415) 956-8686 in San Francisco or (415) 383-5475 in Mill Valley.

Any and all references to Botox® refer to Botox® Purified Neurotoxin Complex which is a registered trademark of Allergan Laboratories, Inc.

Botox® Purified Neurotoxin Complex is an FDA approved medication for various kinds of muscle spasms and spastic rigidity, but has not be specifically approved for treatment of hyperhidrosis or wrinkling. The FDA recognizes the common practice among physicians to use FDA approved drugs and "off-label" uses, particularly in diseases and conditions for which there are limited alternatives.

** Benefits depicted are actual and not retouched.
Patient results may vary. Each set of photos reflects the benefit realized by the person in that set of photos, and not necessarily the viewers final results.

 

Jeffrey H. Binstock, M.D.

SAN FRANCISCO

MILL VALLEY

415.956.8686

415.383.5475

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