Nothing but the truth! Palmar and plantar HH By Dr Davin Lim...
This treatment helps control the symptoms of severe underarm sweating. It works by blocking the chemical signals from nerves that stimulate sweat production. When the signal stops, so does the sweating. This treatment lasts between 6-7 months and only target the sweat glands in the injected areas.
The excessive sweating areas are marked out by the Specialist with your guidance. A guide maker helps the Specialist perform an even number of injections, which ranges from 10-20 sites in each armpit. In some cases we apply numbing cream before the sweat stopping treatments procedure, this makes the treatment pain free.
After injections the areas are compressed with ice packs for 5 minutes, and that’s it! You are right to perform your daily duties, and even exercise a few hours later.
Most patients will start to notice a reduction in sweating within 8 -14 days of treatment. Remember- it takes time before the nerves to the sweat glands are blocked, so be patient. Sweat stopping treatments for armpit sweating is very effective, and this treatment is effective in over 95% of patients.
The improvement in axillary hyperhidrosis (excessive armpit sweating) lasts between 6-7 months for the average patient. Under the current Medicare ruling, patients are entitled upto 3 treatments per year.
*Medicare rebate applies for the treatment of severe underarm sweating not responding to Driclor application. This treatment will need to be performed by a Specialist Consultant trained and approved for this procedure. A rebate can not be claimed for non-specialist use. Medicare approves up to 3 hyperhidrosis injections per year.
Ok, here’s the truth- the injections are easily tolerated by most patients. The injection needle is very small, however at least 10-20 Sweatfree injections are placed into each armpit, and the pain of the procedure is over in 90-120 seconds. Each needle feels like an ant bite.
We give the patients the option of the PAINLESS method- this consists of numbing cream applied to the treated area 30 minutes before the injections, and combined with a state of the art Zimmer Skin Cooler, this now makes it a painless way of getting the sweaty underarms sweat-free!
Yes! Sweatfree injections can be used to treat the following areas:
Excessive sweating of the scalp and forehead area.
Excessive sweating of the hands and feet.
Compensatory or rebound sweating.
NOTE: for excessive sweating of the hands and feet, the preferred method of treatment is Iontophoresis. Sweatfree injections in the hands and feet last between 3-4 months before wearing off, and Medicare does not reimburse this treatment. Sweatfree injections in the hands and feet can have temporary side effects such as weakening of small muscles. This is not seen with injections in the armpit area.
Sweatfree injections are very safe, in fact this procedure has been performed in the United States for the past 15 years, however Australia has only started to approve this treatment under Medicare since June 2012*.
Pregnant women are excluded from Sweatfree injections.
*Under accredited Sweatfree injections Specialist Dermatologist treatment.
Sweatfree injections is not indicted for all cases of excessive sweating. This treatment is reserved for patients in whom other treatments do not work, or in patients who have side effects to tablets or over the counter antiperspirants.
Before considering Sweatfree injections as treatment, try Driclor as the first step. 10-20% of patients with excessive armpit sweating will respond to this over the counter antiperspirant.
Driclor Application - the correct method
Apply to areas of excessive sweating- it may take 7-10 days before you notice an improvement.
Aim for application after a shower, best at night.
Always apply Driclor to DRY skin. I recommend using a hair dryer on the cool setting- make sure as much moisture is gone before application.
Aim for 3-4 nights a week, and if tolerated INCREASE the application frequency to nightly. Remember to wash off in the morning. Do NOT aim for more frequent application as you will eventually develop skin irritation
If skin irritation develops (red, itchy, burning skin), you can try decreasing the amount of Driclor you use, or decreasing the frequency of use.
If you still experience skin irritation despite following all the above instructions, you can apply some Hydrocortisone Cream (get the strongest percentage from your local pharmacist). Apply in the morning, and skip application of Driclor that night.
If Driclor fails (which is often the case in 80% of patients with excessive armpit sweating), then the next stage is Sweatfree injections. You are entitled to a Medicare Rebate for this procedure.
The short answer is ‘yes’…BUT….
Tablets such as anticholineric medications can help decrease sweating however these tablets are associated with side effects such as sedation, constipation and dry mouth. Of all the side-effects, sedation or excessive tiredness is the most common and self-limiting.
If you would like to try these tablets BEFORE considering Sweatfree injections, you may speak to your General Practitioner to prescribe you Propanthelene Bromide 15 mg. I recommend you take one tablet at night, and if you don’t experience side effects, increase to 2-3 tablets per day. Discuss with your doctor the potential side effects and interactions of tablets.
For armpit sweating there are really only 2 other options apart from Sweatfree injections - Iontophoresis or surgery.
Iontophoresis involves electric current therapy to block transmission of the sweat glands. This electric current is delivered by a safe medically prescribed piece of equipment appropriated named as an ‘iontophoresis machine”. This treatment is best used as first line treatment for excessive sweating of the hands and feet, however special pads maybe used for sweating of the armpits. In actual practice this treatment is effective in only 20-30% of patients with axillary sweating.
In brief, highly recommended for excessive sweat on the hands and feet, not recommended for excessive armpit sweating.
Several methods of surgery can be used to treat excessive sweating, including armpit or axillary hyperhidrosis. We recommend surgery as last line treatment for hyperhidrosis (unless the condition is widespread or generalized or is associated with sweaty hands.)
A procedure called Endoscopic Thoracic Sympathectomy involves surgical interruption of the nerves signals between the spinal column and the sweat glands. This procedure is highly specialized and conducted in an operating theatre by a highly skilled thoracic and vascular surgeons.
Two other procedure can be employed to surgically manage excessive sweating of the axillary - armpit areas.
Excision of the axillary vault describes excision of the skin and fat of the armpits- a procedure that was conducted over 20 years ago. This treatment can be effective, however it is associated with significant scarring.
Subcuttaneous Liposuction of the eccrine glands describes a surgical procedure that involves suction of the sweat glands thru a cannula. This treatment can be effective in some patients, however the trauma of surgery can be significant. Most surgeons have replaced this procedure with Sweatfree injections.
Sweatfree injections for excessive sweating is not the first line treatment for all types of sweating, however if you fail other simple anti-sweating methods, it maybe the answer you are looking for.
First of all, have you tried DRICLOR antiperspirant? This can be purchased from most chemists. Make sure you apply this antiperspirant correctly.
Secondly, does sweating really affect your life? If you answer ‘yes’ to the next two questions, this treatment maybe what you are looking for:
Are you self-conscious when you raise your hands?
Does excessive sweating limit what you wear?
A referral is needed for maximal claims that you maybe entitled to. Part of the consultation and treatment fees are covered by Medicare and the PBS. A referral will also enable us to provide a treatment plan to your GP, and keep them up to date with your progress.
Download patient referral form
**You can visit Sweat Free Specialists in Brisbane without a referral, as our Specialist Nurse Educator can take care of the paperwork. With your permission, we also like to communicate with your usual GP to inform them of your treatment progress. This can reinforce to doctors that sweat treatments are effective in the majority of cases.
Dr Davin S. Lim
Consultant Laser Dermatologist
Sweat Free Clinics
Westside Laser and Cosmetic
Injections for excessive sweating has revolutionized treatment for this condition. With out prejudice to our healthcare system, it has taken Medicare the greater part of a decade to approve this treatment. The impact of the true hyperhidrosis patient cannot be dismissed or underestimated, as this medical treatment can be life changing. Patients can wear what they want, when they want, it can change social behavior, and add an immense amount of confidence and well being to the patient.
The use of Driclor is certainly first line treatment, however patients who fail to respond or tolerate this treatment, the use of Sweatfree injections can be extremely effective. Treatment is well worth it, if the impact of excessive sweating is significant.