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Excessive Sweating

Excessive Sweating, also recognised as Hyperhidrosis

Hyperhidrosis also described as excessive sweating, beyond a level needed to maintain normal body temperature in response to heat exposure or exercise. Hyperhidrosis can be classified as either primary or secondary. Primary hyperhidrosis is idiopathic in nature, usually involving the hands (palmar), feet (plantar), or axillae (armpits). Secondary hyperhidrosis can be an outcome from a diversity of drugs, such as tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), or underlying diseases/conditions, such as febrile diseases, diabetes mellitus, anxiety or menopause. Gustatory hyperhidrosis is an uncommon iatrogenic cause of facial hyperhidrosis in response to hot or spicy foods, resulting from surgery to the parotid gland and subsequent aberrant regenerating parasympathetic fibers.

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The consequences of hyperhidrosis are primarily psychosocial in nature. Excessive sweating may be socially embarrassing or may interfere with certain professions. For example, palmar hyperhidrosis may impede art work, working with electrical components, or playing certain musical instruments. In addition, hyperhidrosis may lead to a demand for several changes of clothing a day; excessive sweating may also result in staining of clothing or shoes.

  • The consultation

    The Surgeon will help the patient to reach a decision re: treatment. The options are:

    1 – Armpit skin resection and gland debulking. Also known as open adenectomy:

    It is a surgical procedure that is often performed under local anaesthetic and sedation, involves removal of an ellipse of skin and sweat gland from the armpit. It creates a 4cm scar in the hair bearing skin in the axillae (armpit) and gives a long lasting result.

    2 – Botulinum Toxin:

    Sweat glands need a nerve impulse to activate. Without this stimulation, they won’t secrete. With injecting Botox into problem areas such as underarms, hands and feet, the related nerve impulse is temporarily relaxed and prevented from reaching the sweat gland. This, in turn, stops sweat production in the treated area. The treatment is as simple as it sounds. All patients report a substantial reduction in sweating within two days. Better still, many patients don’t sweat at all following treatment. Repeat treatment is generally recommended within 3-6 months. An injection into the armpits and hands has been shown to be very successful. Good results can be achieved after a single injection session and lasts up to 6 months. By Laith Barnouti


  • Patient will be going home with minimal discomfort, simple analgesic will be adequate to control the discomfort.

    Getting you back to work and regular activities

    You are able to return back to work the day following surgery as long as it does not involve heavy duty work or stretching the arms above the shoulders.

    Back to full normal activities in 7 days time.

    Do the Botox injections hurt?

    A small disposable syringe with a micro needle is used. When treating the armpits, palms and soles most patients discover the injections just cause mild, temporary discomfort.

    How will the area look after treatment?

    Instantly after the injections there may be mild swelling, which normally subsides within 24-48 hours.

    Application of cold (i.e. ice pack) for a few hours after treatment will help reduce any swelling.

    Side effects of this treatment are uncommon. The most common are minor discomfort, redness, swelling and mild bruising, which generally last between 24 and 48 hours. If you are pregnant or breast feeding, if you suffer from neurologic conditions (myasthenia gravis, myopathies), or if you are taking medications like Ca Blockers or Quinolone Antibiotics (Ciprofloxacin, Ofloxacin, etc.), the treatment is not recommended.

    How many treatments will I need?

    Clinical trials accounts that repeat treatments are usually required initially every 6 months then every 9-12months period. By Laith Barnouti