Hyperhidrosis is the condition characterized by abnormally increased perspiration, in excess of what is required for auto - regulation of body temperature. In such condition, the sudoriparous (sweat) glands are overly sensitive to neural stimulus coming from the brain and cause excessive perspiration. The main function of sweat is to regulate the body temperature by cooling the skin surface during evaporation. The hyperhidrosis symptoms usually begin during puberty (9 - 16 years) and continue during the entire life, with fluctuations in intensity depending on the person’s psychological - physiological conditions. The causes of excessive sweating are unclear, although there are several physical and psychological mechanisms. The cause can often be related to the exaggerated innervations of sweat glands and the condition is exacerbated by psychological - emotional stress. Other causes might be related to diseases of the thyroid gland (hyperthyroidism), disorders of the endocrine system, alcoholism, peripheral neuropathies, some types of tumors, obesity, etc. Sweat is mainly produced (75%) in the sudoriparous glands of the upper and lower extremities, therefore the most affected areas are armpits, hands, feet, as well as the inguinal - genital and popliteal (back of the knees) areas. This worrisome and annoying condition is present in any season as it often does not depend on temperatures, although it is increased during summer.
When it comes to social life, persons affected by hyperhidrosis oftentimes experience problems related to low self - esteem and self - isolation from the society. Even regular work and everyday activities can turn into physical as well as psychological problems. The excessive sweat, in addition to the expected annoyance for the affected persons, can become a cause of bacterial accumulation in the skin. These microorganisms produce unpleasant odors due to the fermentation process. Due to the above, some basic hygienic rules are highly recommended, such as: use of soap and detergents which respect the skin pH, frequent hand wash, avoidance of irritating substances, careful treatment of skin lesions (even the smallest ones), avoidance of alcohol, smoking, coffee, spicy foods, etc.
In addition to the invasive techniques such as the surgical interventions (sympathectomy), nowadays the hyperhidrosis can be treated with very satisfactory results through the injection of botulinum (Botox®). This medicament contains purified botulinum toxin of type A. Its injection blocks the release of acetylcholine at the pre - synaptic nerve endings, and as a result, the transmission of the nerve impulse (see also “Botulinum (Botox®)”). Through this mechanism, the production of sweat from the sudoriparous glands is blocked. Although the botulinum has been in use for many years, it should be noted that it must be applied only by experienced doctors in specialized clinics. Botulinum treatments should not be applied by inexperienced persons. It is also strictly forbidden to perform auto - injections since the associated damages could be serious.
The Botox® treatment is comfortable and pain is slight and quite tolerable, therefore there is no need for anesthesia. It is performed by qualified personnel under ambulatory regime and can last in average 15 - 30 minutes, depending on the areas to be treated. There is no post - treatment recovery period; normal everyday activities can be immediately resumed. As a first step, the interested person will have a preliminary consultation session with our expert. The doctor will explain the procedure in details; thereon he will carefully assess the areas to be treated, the potential outcomes, side effects, contraindications, etc. After determining the skin area to be treated, the person lies comfortably in a special bed. Uniform injections are performed through a fine needle in the determined areas (according to the specific necessities) such as armpits, hands, inguinal-genital area, etc. Results are very satisfactory and usually last 4 - 8 months. After this period, sweating will gradually resume, but oftentimes, the previous sweating levels are not reached even one year after treatment. In most cases, one treatment per year is sufficient to reduce and control the hyperhidrosis condition; usually it is preferable to apply it before summer. Unfortunately, about 5 - 10% of people are not responsive to botulinum injection due to their physiological features (anti - botulinum antibodies) and therefore the results are not satisfactory. Side effects are very rare, slight and disappear within a short time.