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Botulinum toxin type A is a natural protein made by a specific bacterium called Clostridium botulinum. The protein is removed from the bacteria and then specially prepared before use. It is an injectable muscle relaxant, commonly known by one of its trademarked brand names, BOTOX®.
Botox® has been available for over 20 years and is now used widely to treat various medical problems, such as hyperhidrosis.
Hyperhidrosis is defined as excessive, uncontrollable sweating without any discernible cause. It most commonly involves the axillae, palms, and soles.
Increased sweating is a normal response to a rise in body temperature, and to emotions such as anxiety. Sweating is controlled by the brain, which sends signals along nerves called “sympathetic nerves” to the small sweat glands in the skin.
Visible sweat, wet clothes and clammy palms can be embarrassing and can interfere with work and personal relationships.
When small doses are injected into the skin, it blocks the signals from the nervous system that supply the sweat glands. It does this by stopping the release of a chemical called acetylcholine. This results in the reduction of sweating.
How long will the Botox work for?
In hyperhidrosis, Botox helps to stop or significantly reduce the symptoms. This will usually happen within two weeks of treatment, and the effects may last between two to six months, although some patients may continue to benefit for 12 months, and the treatment can be repeated.
When the Botox® wears off, your condition will return to its previous state – it will not worsen, and there is no permanent effect.
The treatment is effective at reducing sweating for most people with axillary hyperhidrosis. The effects of the Botox® should be evident within five to ten days after the treatment. However, 5-10% (between 1 in 20 and 1 in 10) of patients report no improvement.
The areas that require treatment will be cleaned and marked with a surgical marker. An anaesthetic cream may be applied to numb the area before the procedure.
The exact number of injections needed varies from person to person, but on average, 25 to 30 small injections of Botox® per armpit are administered a few centimetres apart. The whole procedure usually takes around 30 minutes. Some discomfort is normal.
You should keep the area clean and try not to rub the injection sites for the first 24 hours, which may affect how well the treatment works. Avoid exposure to extreme heat and avoid exercise for 48 hours after the treatment.
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