What causes excessive palmar perspiration?
Hyperhidrosis is the medical term for excessive perspiration. When it occurs on the palms it is called "Palmar Hyperhidrosis". This is caused by stimulation of the eccrine sweat glands (pronounced ek'-krine) by the nerve endings which are the final nerve pathways from higher centers in the brain. These nerves respond to different kinds of stress such as: emotional stress like intimate social situations or public speaking. Also physical stress like the increased body temperature that comes with exercise or hot and humid weather can increase perspiration. Emotional stress, being physically active, or over-heating can cause of excessive perspiration for others. In either case, Botox® Purified Neurotoxin Complex* may be the answer. The nerves that control perspiration depend upon a chemical transmitter called acetylcholine. Botox® is a genetically engineered neurotoxin which can, when injected into the skin, block the release of the acetylcholine to the sweat glands for months!
What are the alternative treatments for Palmar Hyperhidrosis?
Topical Antiperspirants
Topical antiperspirant sticks, creams, lotions, and solutions typically use aluminum chloride solutions. They are highly irritating with continued use, and largely ineffective for people with excessive perspiration.
Anti-cholinergic drugs & tranquilizers
Medications currently used cause dry mouth, blurred vision and minimally reduce perspiration.
Tap Water Iontophoresis
Various battery powered electrical devices have been used over the years. They typically use a tap water moistened pad and electrical current held against the palms for several hours. This decreases the perspiration but is very time consuming, as it needs to be repeated on a daily or weekly basis. Which is only mildly effective for severe cases.
Surgery
Thoracic surgeons and neurosurgeons use a fiber-optic surgical tube inserted into the neck or through the underarm skin to cut the nerve fibers next to the spine. These nerve fibers lead to underarm sweat glands and palms (endoscopic sympathectomy or ETS). This approach involves the risk of localized paralysis. Also, loss of sensation, and even drooping eyelid or permanent dilation of the pupil of the eye as reflex injury. Some cases of compensatory hyperhidrosis have been reported wherein there is an unwanted increase in perspiration.
How is BOTOX® given?
A very small needle is used to inject small drops of Botox® into the palmar skin of the hand in approximately 30 places. The procedure takes only a few minutes in the office and requires no anesthesia. While patients may engage in any normal activity, heavy exercise should be avoided for several hours. We prefer to treat one hand first and the other hand in one week.
When will BOTOX® take effect?
Your palmar perspiration will decrease within 48 hours. In about 1 to 2 weeks you can expect to see the full effects.
How long does BOTOX® last?
Most patients will obtain 6 to 10 months of dryness after treatment with Botox®.
What are the risks and complications?
The only complications from injection into the palmar skin are:
1) Tiny bruises may occasionally occur. This will fade after a few days.
2) Small persistent areas of perspiration may need a second treatment session.
3) Some temporary weakness in grip strength which may last up to two weeks. There is no risk of numbness, or permanent weakness.
Who are good candidates for "No Sweat" Botox® to treat Palmar Hyperhidrosis?
-Those with unwanted palmer perspiration
-Anyone working close to others who need to touch: hairstylists, nurses, dentists and hygienists, MD's
-Retail workers who handle sensitive material: salespeople in clothing, jewelry, stationary, accessories
-Workers in hot conditions: models, television newscasters, chefs and photographers
-People handling lots of paper: executives, attorneys, salesmen, stockbrokers and title company workers
-People who need to use keyboards extensively: typists, computer programmers and software engineers
-If you handle money: cashiers, tellers and reception desk personnel
What conditions does this treatment help?
-Slippery hands on steering wheels
-Magazines slipping out of your hands
-Ink rubbing off of newspapers on your hands
-Problems writing handwritten letters and notecards
-Moist handshakes when meeting people
-Anxiety about excessive perspiration
Botox for Palmar Hyperhidrosis
If you are interested in learning more about Botox for Palmar Hyperhidrosis, please email us or contact our office for an appointment.
Any and all references herein to 'Botox®' refer to 'Botox® Purified Neurotoxin Complex', which is a registered trademark of Allergan *Botox® Purified Neurotoxin Complex is an FDA approved medication for various kinds of muscle spasm and spastic rigidity, but has been specifically approved for the treatment of hyperhidrosis only in the axillary (underarm) area. The use of Botox® for treatment of palmar perspiration is a so-called "off label" use. The FDA recognizes the common practice among physicians to use FDA approved drugs in so-called "off label" uses. Particularly in diseases and conditions for which there are lesser alternatives. Botox® Purified Neurotoxin Complex is a registered trademark of Allergan Herbert Laboratories, Inc.