AESTHETIC MEDICINE
An aesthetic doctor normally treats these patients with Botulinum Toxin Type A injections, to block the nerves in the hands, feet and underarm pits that trigger the sweat glands.
THE TREATMENT of this disease can BE COMPLICATED if the CORRECT DIAGNOSIS is not made. It is thus VERY IMPORTANT that patients WITH EXCESSIVE SWEATING are seen and treated by the CORRECT MEDICAL DOCTORS, such as DERMATOLOGISTS or qualified aesthetic doctors.
Pre-treatment evaluation
This evaluation will be done by the medical doctor and involves the decision of either (1) a surgical treatment, or (2) a non-surgical treatment.
Injection techniques
Botulinum Toxin Type A is a safe, effective and durable method to treat patients with hyperhidrosis in the non -surgical category. It is not given to patients with an underlying disease. The hair bearing area is used to define the injection area to inject the toxin (50 units used per axilla, about 8mm apart).
Palmar and plantar treatment
This procedure is also done without anaesthesia and can cause severe pain. A very effective, low risk and convenient way of treating this area prior to the injections is called cryo-analgesia. It entails placing ice-packs on the area for 15 minutes prior to injection to cool it. Topical 2,5% Lidocream can also be applied. The injection field is a grid on the palm and sole and 100 units of toxin is used per area.
Post treatment care
Photo by Ketut Subiyanto from Pexels
Complications of the disease
If the excessive sweating is not treated, it can lead to complications such as nail infections, warts and heat rash, as well as psychological impacts (i.e. losing jobs, conflicts and loss of self-confidence). It is thus very important to inform people that excellent treatment for sweating severely is available. The average time frame for hyperhidrosis patients to respond to the acceptance of their disease is about nine years! While it is not a life-threatening disease, it causes embarrassment and an uncomfortable lifestyle.
Muscle weakness is the most published adverse complication, but fortunately only for a short period (three days). Patients are informed about this possible after-effect and encouraged to report any adverse event to their medical doctor. Follow up consultations are recommended about two weeks after the treatment.
Patient satisfaction
The decrease in occupational, emotional as well as the difficult social situations are a significant claim that Botulinum Toxin Type A injections, done by qualified medical doctors, improve the patient’s quality of life.
Summary
Symptomatic hyperhidrosis in the axillary, palmar and plantar regions can be effectively treated with Botulinum Toxin Type A in a safe, relatively durable and effective way at a reasonable cost, and with no down time for the patient.
Treatment
Botulinum Toxin Type A is the best treatment for focal hyperhidrosis. The most useful area for this specific treatment is for the axillary (underarm) area. Botulinum Toxin type A is also highly effective in treating the palmar and plantar (sole of the foot) areas. This treatment is normally highly effective for about nine months per year, with high satisfaction rate amongst patients.
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Dr Ronel Du Toit M.B.Ch.B (Stellenbosch) has been an aesthetic practitioner since 2002 in the Northcliff and Illovo Johannesburg area. She is an accredited aesthetic doctor with unique credentials and attends on average between four to five congresses, workshops and talks per year to stay academically well informed about world trends and developments.
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