Treatment review: Botulinum toxin for hyperhidrosis

Contributing reporter Kezia Parkins tried botulinum toxin for hyperhidrosis… but did she stop sweating?

I've been an excessively sweaty person ever since I hit puberty. It has caused me a lot of embarrassment and affected my mental health. I always think people are staring at me and thinking “What’s wrong with her?”, and I often get questions like “Why is your face all wet?” or “You’re so sweaty, are you okay?” Although I know that it’s just normal for me, the more attention is drawn to my condition, the more I worry and the worse it gets.

Hyperhidrosis affects my entire body, apart from my limbs. It is especially bad on my head and face, armpits, back and groin area.

It’s hard to say exactly what my sweating is caused by but if I had to guess I would say a cocktail of hormone imbalances and social anxiety.

On a hot day at Élan Laser Clinics on Portman Square, Dr Dean Rhobaye warned me during my consultation that, if my sweating is due to hormones, I would be likely to receive little to no benefit from the toxin, which made me break out into a sweat!

I lay on the treatment bed with my arms in the air while numbing cream was applied. Dr Rhobaye drew cross-hatched markings on my numbed pits that somehow tickled unbearably, despite the extended numbing time of around an hour. However, I couldn’t feel the injections at all, despite having 40 in each armpit.

I was told it could take around two weeks for the toxin to take full effect. Lo and behold, within that period, my sweating reduced by around 70%.

The off-label treatment works by blocking the release of the neurotransmitter acetylcholine, which binds with your sweat glands to signal the release of sweat. The nervous system typically activates your sweat glands when body temperature rises as a mechanism of cooling itself. With hyperhidrosis, the nerves that signal the sweat glands are working overtime.

Receiving toxin injections directly to the area that commonly sweats essentially paralyses the overactive nerves. Your nerves can’t signal your sweat glands, so you don’t sweat. Around six weeks later, one of my armpits was sweating considerably, but still probably less than your average person.

I was told it was normal to need a top-up around this point to maximise treatment results, so I went back to see Dr Rhobaye, this time skipping the numbing cream. The procedure was still practically painless.

Within a few weeks, I had two almost dry armpits. I still sometimes sweat a tiny amount but it is manageable.

I can’t overstate the relief this treatment has given me, and the improvement it has made to my quality of life. It is a shame the treatment is no longer available on the NHS. Despite being warned that the treatment may cause me to sweat more in other areas, I would say that in fact, I have been sweating less all over thanks to reduced anxiety.

This is a truly life-changing treatment for those affected and shows the broad value of aesthetic medicine. Six months on, I am still a lot more confident, but, as is to be expected, the toxin is starting to wear off. I will be doing the treatment again, perhaps in other areas as well.