1. What characterizes hyperhidrosis?
It is sweating that exceeds the body's need to control its temperature. The patient sweats excessively even in air conditioning, at rest, or during cold winters.
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2. Is anxiety the cause of the problem?
Stress and anxiety are triggers, but not the root cause of primary hyperhidrosis. The condition is genetic, and the patient's autonomic nervous system is hyperactive by nature.
3. What is the difference between hyperhidrosis and bromhidrosis?
Hyperhidrosis is an excess in the amount of sweat. Bromhidrosis is an alteration in the quality of the sweat, generating a foul odor due to bacterial degradation.
4. Is there such a thing as emotional excessive sweating?
Yes. Many patients only suffer severe sweating crises when they are under pressure, in meetings, exams, or dates, which characterizes adrenaline-mediated sweating.
5. What is primary focal hyperhidrosis?
It is the type that affects specific and symmetrical areas, such as the armpits, palms of the hands, soles of the feet, and face. It usually appears in childhood or adolescence.
6. What is secondary hyperhidrosis?
It is sweating that occurs as a symptom of a disease (such as hyperthyroidism, diabetes, infections, tumors) or the use of certain antidepressant medications. It affects the entire body.
7. Is Botulinum Toxin (Botox) treatment permanent?
No. The toxin paralyzes the sweat glands temporarily. The effect lasts between 6 and 9 months, requiring reapplication to keep the area dry.
8. If I block armpit sweat, will it come out of my back?
In Botulinum Toxin treatment, so-called "compensatory sweating" is extremely rare, unlike surgery (sympathectomy), where it is very common.
9. Does the underarm application hurt a lot?
The procedure in the armpits is very well tolerated. We use potent anesthetic creams and ice packs to minimize any discomfort.
10. Can Botox be applied to the hands?
Yes! Palmar hyperhidrosis is one of the types that most affect the patient's life (work, biometrics, holding objects). The application improves quality of life by 100%.
11. And on the feet? Is there a treatment?
Yes, plantar hyperhidrosis also responds very well to Botulinum Toxin, reducing sweat, slipping in open shoes, and helping to prevent odor.
12. Do clinical antiperspirants solve the issue?
Products containing 15% to 25% aluminum chloride help in mild cases. However, many patients give up because of itching, redness, and burns in the armpits.
13. Is there oral medication for sweating?
Yes, anticholinergics (e.g., oxybutynin). They reduce sweat but "dry out" the entire body, causing dry mouth, dry eyes, constipation, and drowsiness.
14. What is a Sympathectomy?
It is a definitive thoracic surgery that cuts or clips the sympathetic nerve. It resolves sweating in the hands and armpits but carries a high risk of severe compensatory sweating (abdomen, groin, and back).
15. Can children undergo the treatment?
Botulinum Toxin application can be done on adolescents with severe hyperhidrosis, provided there is a medical indication and parental approval.
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16. What is the miraDry treatment?
It is a microwave technology that permanently destroys axillary sweat glands. It is a modern alternative to surgery, focused only on the armpit.
17. Is excessive night sweating hyperhidrosis?
Night sweats that soak bedding are not typical of primary hyperhidrosis. They require immediate investigation to rule out systemic diseases or menopause.
18. Does laser hair removal reduce sweat?
Laser hair removal destroys the hair root, helping a lot with odor control (bromhidrosis), but it has no direct action on the sweat glands.
19. Can I play sports after Botox application?
We recommend avoiding intense physical activity, very hot baths, or saunas for the first 24h to 48h to prevent unwanted dispersion of the toxin.
20. Does Botox on the forehead stop facial sweating?
Yes! Craniofacial hyperhidrosis affects the forehead, scalp, and upper lip. The application of botulinum toxin in these areas is highly effective in keeping the face dry.
21. Do men get this treatment?
Yes, very often! The main male complaint is embarrassment at work: shirts with the famous "pit stains" under the arms or soaked hands when shaking hands to close a deal.
22. Does hyperhidrosis go away with age?
The tendency is for it to decrease slightly in old age, but many patients spend their whole lives suffering if they do not seek dermatological help.
23. What clothes should I wear or avoid?
Avoid polyester, nylon, and elastane, as they "trap" heat. Invest in 100% cotton, linen, or fabrics with anti-perspirant technology (Dry Fit).
24. Does drinking a lot of water increase underarm sweat?
Not at all. Drinking water only regulates your temperature and hydrates you. Restricting water will harm your kidneys, but it will not cure your hyperhidrosis.
25. Can pregnant women be treated with Botulinum Toxin?
No. For safety reasons, no injectable aesthetic or elective treatments are performed during pregnancy and breastfeeding.
26. Is there a blood test to discover hyperhidrosis?
Primary hyperhidrosis is diagnosed clinically in the office. Blood tests (Thyroid, Glucose) are requested to rule out secondary hyperhidrosis.
27. What is the Iodine-Starch test?
It is a test done in the office (Minor's Test). The doctor applies iodine and starch to the skin; when sweating occurs, the area turns black, allowing exact mapping of where to apply the Botox.
28. Does excessive sweating damage the skin?
Yes. The constant moist environment (maceration) favors the proliferation of fungi (mycoses, athlete's foot) and irritant dermatitis, especially on the feet and groin.
29. How long does it take for Botox to work on the armpits?
The paralysis of the glands begins in about 3 days, reaching the effect of total (or almost total) dryness in 14 to 15 days after the session.
30. Is the evaluation consultation very important?
Fundamental. Only during the consultation will Dr. Caroline Minchio be able to determine if your case is primary or secondary and propose the safest treatment for your body type.