Treatment of Excessive Sweating Summary:
The treatment of excessive sweating takes into account the severity of your symptoms and the impact on the quality of your life. Sweating more than necessary may lead to stress, anxiety and depression. There are various options for the treatment of excessive sweating. They range from topical medications to surgery. Choosing one that is safe, affordable and provides long-lasting relief are now possible.
What is Hyperhidrosis?
Did you know? The Japanese are 20 times more likely to suffer from sweaty palms compared to other ethnic groups. Sweating is a normal response to increased body temperature. Sweating more than necessary, and even at rest can be a frustrating experience. Excessive sweating can have a profound effect on one's social life, occupational performance and psychological well-being. Hyperhidrosis is the medical term to describe excessive sweating, a condition that affects about 3% of the population. Hyperhidrosis is due to an overactive nerve input that stimulates the sweat (eccrine) gland.
Hyperhidrosis Disease Severity Scale (HDSS)
How is excessive sweating affecting your life? The hyperhidrosis disease severity scale is a validated tool to select patients for therapy and to assess response to treatment. A score of 1 to 2 is rated as mild to moderate, while a score of 3 or 4 is considered severe. After treatment, a 1-point and 2-point improvement correlates with a 50% and 80% reduction in sweat production respectively.
Treatment of Excessive Sweating
There are various options to manage hyperhidrosis, with varying degrees of success and advantages and disadvantages. They include topical aluminium salts, iontophoresis, botulinum toxin injections, oral medications, lasers, microwave devices and surgery.
Topical antiperspirant therapies such as aluminum chloride may cause skin irritation, stain the skin and have short-lasting effects. Oral medications are associated with various side effects such as dry mouth, blurred vision and constipation.
Surgical sympathectomy is usually reserved as a last resort for excessive sweating. It is invasive, associated with multiple complications and is by no means 100% curative. Recurrences of sweating are known to occur following surgical sympathectomy.
How does Botulinum Toxin Injections Work?
How does Botulinum toxin work on the sweat glands? The human sweat (eccrine) glands are activated by the chemical acetylcholine. Botulinum toxin therapy prevents the release of acetylcholine from the nerves, thus reducing sweating.
Botulinum toxin therapy has FDA approval for focal underarm hyperhidrosis that has not responded to topical treatments. A study found botulinum toxin more effective than topical 20% aluminium chloride for the treatment of excessive sweating.
A starch-iodine test is carried out to map the areas involved before commencing botulinum toxin injections. Botulinum toxin treatments for hyperhidrosis are safe, effective, and retreatments can be done every 6-7 months.
INFINI Underarm Treatment of Excessive Sweating
The INFINI treatment is a novel fractional micro needling treatment that delivers radiofrequency energy to precise depths of the skin.
The INFINI treatment is able to destroy the sweat glands at the desired depth using direct thermal energy. The sweat (eccrine) glands can be found at the junction between the dermis and fat layer of the skin. Using gold insulated needles, we can control with precision the depth of thermal energy to be delivered. The INFINI can reach depths of up to 3.5 mm from the skin surface.
This treatment has the added advantage of sparing the top epidermal skin layers, as thermal energy is only delivered to the deeper dermal layers.
INFINI Hyperhidrosis Treatment
Where are most of the sweat glands found?
In humans, most of the sweat glands are concentrated on the palms, soles, and head, and much less over the body and limbs.
We have about 2 million sweat glands found in the skin. The sweat glands in your underarms account for only 2-3% of the total number of sweat glands.
After removing these sweat glands from your underarm, you will still be able to perspire normally.
What is the treatment like?
Step 1: A starch iodine test is performed to define the areas with the most concentrated sweat glands in your underarms.
Step 2: Numbing cream is applied to maximise your comfort during the procedure. This is cleansed off after 45 mins.
Step 3: The INFINI treatment is carried out to destroy the sweat glands. Most individuals experience little or no discomfort as the skin is numbed. The skin is repeatedly cooled during and after the procedure to enhance comfort.
After the procedure, the treated area is dressed with a special material to facilitate healing.
How many treatments will I need?
Most individuals only need one treatment for permanent sweat reduction. However, a second treatment one month later can further improve hyperhidrosis in more severe cases.
The sweat glands once destroyed do not regenerate. This leads to longer lasting results.
As with any treatments, the results vary from person to person.
What are the side effects ?
The INFINI treatment is safe for all skin types. After effects of the procedure include temporary discomfort, redness, swelling and pigmentation of the skin. In some cases there may be some temporary numbness of the axillary skin as some nerves may be damaged during the procedure.
A phenomenon known as compensatory hyperhidrosis can occur after treatment. This may be due to the body's way of adjusting to the loss of sweat glands destroyed during the procedure.
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- Flanagan KH, King R, Glaser DA. Botulinum toxin type a versus 20% aluminium chloride for the treatment of moderate to severe primary focal axillary hyperhidrosis. J Drugs Dermatol. Mar 2008:7(3):221-7
- Kim M, Shin JY, Lee J. Efficacy of Fractional Microneedle Radiofrequency Device in the Treatment of Primary Axillary Hyperhidrosis: A Pilot Study.Dermatology 2013;227:243-249
- Farahnaz Fatemi Naeini, Bahareh Abtahi-Naeini, Mohsen Pourazizi et al. Fractionated microneedle radiofrequency for treatment of primary axillary hyperhidrosis: A sham control study. Australasian Journal of Dermatology. 2015;56(4):279-284
- Purtuloglu T, Atim A, Deniz S, Kavakli K, Sapmaz E, Gurkok S, et al. Effect of radiofrequency ablation and comparison with surgical sympathectomy in palmar hyperhidrosis. Eur J Cardiothorac Surg. 2013 Feb 21.