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Condition
Hyperhidrosis

Many people who complain of excessive sweating have a condition called primary hyperhidrosis. This disorder is characterised by excessive, bilateral and symmetrical sweating, most commonly affecting the axillae (armpits), palms, feet and face. This normally occurs during the day, stopping during sleep.

Sweaty hands and fingers can be noted in childhood, and in particular when at school, the child complains of a lack of grip when holding a pen and making wet marks on the paper The fingers can become swollen, cold and red after many years, and by adult age, the social embarrassment is such that patients fear meeting people and shaking hands.
It can also be evident following puberty, affecting mainly the armpits, triggered mainly by emotion rather than physical exercise and excessive heat. Excessive axillary sweating can be intolerable as it stains clothes and leave wet marks under the arms which is very embarrassing. Patients hide it by wearing dark clothes or keeping a jacket on even in summer. Some of them have to shower during the day or bring clothes to work in order to keep themselves dry. It’s a familial condition in 50% cases.
Excessive sweating of the feet will prevent women to wear open sandals iand n particular high-heeled shoes as the wet feet slip into the shoes. Many patients are used to having wet socks all day long.

Excessive sweating of the face is socially embarrassing as the sweat drips along the face from the forehead, and sometimes from the eyebrows into a pair of glasses.

Treatment

Botulinum toxin injections into the armpits can stop the sweating for 6 to 9 months. There is no major side effect and the injections are not painful.
Botulinum toxin injections for hand sweating required the use of local anaesthesia with Ametop gel and ethylchloride spray to decrease the pain of the injections at 10 sites per hand.

Young adults usually tolerate well these injections, which can dry the hands for 3 to 6 months depending on the severity of the hyperhydrosis. Side effects include small haematomas and transient weakness of the small hand muscles. We do not perform injections in the feet because of the pain and the difficulty of access between the toes.

Excessive sweating of the forehead can be easily treated. Other therapeutic options for hyperhydrosis are local cream, iontophoresis, which needs to be repeated during the week and surgery (endoscopic transthoracic sympathectomy), but with the risk of serious side effects such as compensatory sweating.

 

ARMPITS
Botulinum toxin injections into the armpits can stop the sweating for between 6 to 9 months. There are no major side effects, and the injections are not painful. Ethylchloride spray can be used locally if the patient feels the discomfort of the injections

HANDS AND FEET
Botulinum toxin injections for hand sweating required the use of local anaesthesia with Ice, and ethylchloride spray to decrease the pain of the injections .Young adults usually tolerate well these injections, which can dry the hands for 3 to 6 months depending on the severity of the hyperhydrosis. Side effects include small haematomas and transient weakness of the small hand muscles. We do not perform injections in the feet because of the pain and the difficulty to access between the toes.




FOREHEAD
Excessive sweating of the forehead can be treated, either by injections following the hairline, or by injections in the forehead and sometimes in the eyebrows, depending of the individual pattern of sweating of the patient.
Other therapeutic options for hyperhydrosis are local cream, iontophoresis, which needs to be repeated during the week and surgery (endoscopic transthoracic sympathectomy), but with the risk of serious side effects such as compensatory sweating

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Expression Lines
Palmar hyperhidrosis

Sweat mark

Dripping armpit
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Wilbraham Place Practice - 9a Wilbraham Place - London - SW1X 9AE
 
 
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