Prof. Alessio Redaelli

Aesthetic Medicine
Specialist in Vascular Surgery

Botulinum Toxin for hyperidrosis

The botulinum toxin has been used for many years now for neurologic and oculist use and has been very helpful for many diseases as spasmodic stiff neck, strabismus, blepharospasm and thousands of patients underwent the treatment! Since 1987, two Canadian partners, both ophthalmologists, the Carruthers had a genial idea to use this toxin for mimic wrinkles. Thanks to this, in the field of aesthetic medicine they are very famous and very requested for conferences and teachings. Since then, the use of the toxin has been exponential thanks to its best results and the almost total absence of dangerous collateral effects. In Italy, botulinum toxin has been authorized for aesthetic use for few years now and it can be used only for the glabella wrinkles, those between the eyes. For any other indications has an off-label use (there is not the indication on the information leaflet), and so the doctor takes the responsibility to do it and the patient has to be aware of it. Not everyone knows that the botulinum toxin can be used with a great benefit and without particular collateral effect also for the exaggerated perspiration, scientifically called Hyperidrosis. The body automatically regulates the sudoriparous glands and in some cases they produce an excessive quantity of perspiration. This symptom can cause a great discomfort for patients who suffer from it: perspiration of the armpits, hands and feet that cause an altered life because of it. There are not yet cares and the old treatments, in particular the surgical one, were very invasive and with opposite results: after the operation they often caused an excessive dryness. Botulinum toxin revolutionized the care of very unconformable symptom in a way that is not invasive at all and with great results. Collateral effects, if the toxin is well dosed, are “below zero” as I love to say. Hyperidrosis (excessive perspiration) can be found at the level of head, armpits, and breast, at the groin, hands and feet. All these areas can be treated effectively with botulinum toxin. Preparation An anesthetic lotion and on the most painful areas (especially hands and feet) an anesthesia in the nervous spot is applied. In the majority of cases this anesthesia reduces the pain but does not reset it. In fact the injection that are superficial are done with a very thin needle, and they are painful when done on hands and feet, notoriously very sensitive areas. How is the treatment executed? The treatment is very easy: with the eyeliner you mark a net and in the middle of every square you inject a micro dose of active principle. After the injection, the toxin reacts in few days, not immediately, and so the patient needs to wait for the result. It usually takes 7 up to 10 days, but on the information leaflet of Vistabex, is written that in order to have the definitive result you need to wait 30 days. The perspiration will go away slowly. The results are always good and the duration is also great: in fact, we treat patient in spring, so that when it is very hot, the effect will be maximum. So the patient will be treated once a year. I remind that the goal is not a total abolition and sometime it is possible a residual perspiration. Indications Excessive perspiration of armpits, feet and hands, forehead, breasts and back.
Informed Consent–Botulinum Toxin for hyperidrosis