One of the many uses of botulinum toxin
Botulinum toxins may have a scary-sounding name, but it’s just the umbrella term for the famous anti-wrinkle treatment. This injection has long been used by the rich and famous to slow down the passage of time. But there are many other uses for botulinum toxins, and one of them is hyperhidrosis.
So if you’re suffering from excessive sweating, this is one treatment for consideration.
What is botulinum toxin?
Botulinum toxin is a substance produced by Clostridium botulinum. When this bacteria enters the body through contaminated food, through an open wound, or through inhalation, the toxin it produces attacks the nervous system, leading to a disease called botulism. This is characterised by paralysis of muscles and even organs. It does not take a high amount of toxins to cause morbidity and mortality.
It is a testament to humankind’s ingenuity to use this dangerous substance as a treatment for various conditions. In extremely diluted amounts and with processing, botulinum toxins can be used to control conditions that result in involuntary muscle contractions, repetitive eye movements, and neuromuscular dysfunction. But perhaps botulinum toxin is best known for its ability to achieve tight, wrinkle-free, youthful-looking skin.
There are two TGA-approved botulinum toxin formulations, both of which exert their effects through blocking the release of an important neurotransmitter, acetylcholine. The binding of acetylcholine to nerve receptors is crucial for many processes, including muscle movement and glandular secretions.
How does botulinum toxin help with hyperhidrosis?
We have two kinds of sweat glands. Eccrine sweat glands are the most numerous and are found all over the body. Their primary function is to regulate temperature. When the body feels like it’s getting a little too hot, the nervous system produces acetylcholine, which in turn is the chemical trigger for eccrine glands to start producing sweat.
On the other hand, we have apocrine sweat glands. These are much fewer in number, and are concentrated in the axillary (armpits), groin area, and breast area. Instead of responding to acetylcholine, they are triggered by noradrenaline. Noradrenaline is produced when the body feels strong emotions such as distress, fear, pain, and sexual stimulation. The sweat they produce is more viscous, and has a tendency to smell when in contact with bacteria.
What are the advantages and disadvantages of using botulinum toxin for hyperhidrosis?
Botulinum toxin has been used as a treatment for hyperhidrosis for over 25 years. Its safety and efficacy have long been established through numerous studies. Patients have consistently reported a significant decrease in sweat production and an increase in quality of life within 2 weeks of treatment.
Though botulinum toxin injections are more expensive than topical antiperspirants, the first line of treatment against hyperhidrosis, they are much more convenient. The effect of a single session can last from 3-9 months, whereas topical antiperspirants will require at least weekly, if not daily application.
Botulinum toxin is particularly effective for focal hyperhidrosis, or excessive sweating in select parts of the body. Patients with profuse perspiration in the armpits, palms of the hands, soles of the feet, and face or head area stand to benefit the most from this treatment.
Using botulinum toxin may have side effects, although studies show that it occurs in a minority of patients. When used for axillary hyperhidrosis, there may be temporary itchiness or bruising. When used for palmar hyperhidrosis, there may be temporary weakening of the hand-grip.
How is botulinum toxin used for hyperhidrosis?
Botulinum toxin can only be administered by a licensed medical professional. Always consult your doctor before pushing through with this treatment, as some medical conditions may contraindicate its use, even at such a miniscule amount.
When injected by dermatologists, there is a Medicare subsidy that applies making the treatment more affordable. Certain criteria need to be met however, so its best to make an appointment to check your suitability.
The area is first cleansed and then marked appropriately. Various pain-reduction techniques are used at Melbourne Skin & Dermatology to ensure a comfortable treatment. Multiple injections are then applied to the treatment area. The markings are then washed off and the patient is good to go back immediately to unrestricted activities.
Purpose of this information
The information presented on this website and in this article is for general information and example purposes only, does not contain health advice specific for users and must not be relied on for that purpose. Please see your GP, dermatologist or other health care professional for specific advice.
de Almeida, A. R., & Montagner, S. (2014). Botulinum toxin for axillary hyperhidrosis. Dermatologic clinics, 32(4), 495–504. https://doi.org/10.1016/j.det.2014.06.013
Doft, M. A., Hardy, K. L., & Ascherman, J. A. (2012). Treatment of hyperhidrosis with botulinum toxin. Aesthetic surgery journal, 32(2), 238–244. https://doi.org/10.1177/1090820X11434506
Hodge BD, Sanvictores T, Brodell RT. Anatomy, Skin Sweat Glands. [Updated 2021 Aug 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482278/
Nigam, P. K., & Nigam, A. (2010). Botulinum toxin. Indian journal of dermatology, 55(1), 8–14. https://doi.org/10.4103/0019-5154.60343