Hyperhidrosis is a pathological form of sweating in which an excessive amount of sweat is secreted. This perspiration is often concentrated in certain areas such as the armpits. More rarely, the entire body is affected by hyperhidrosis. It is estimated that between 1 and 2.5 million people in Germany alone suffer from hyperhidrosis. In addition to unpleasant wetness and odors, it is above all psychological stress that those affected have to bear. They are often ashamed when outbursts occur in public and sometimes even avoid social contact. In addition to surgical hyperhidrosis treatments such as so-called sweat gland curettage, there are also minimally invasive and non-surgical methods to control excessive sweating. One of these procedures is the injection of Botox®.
(Image: © dream@do – stock.adobe.com)
The function of sweating
Even if sweating is primarily perceived as unpleasant, it nevertheless fulfills very important tasks for the human body. We use sweat to regulate our body temperature. This is particularly noticeable in hot outside temperatures, during sport or during fever attacks. Sweat evaporates on the surface of the skin. The evaporative cooling then provides cooling and causes the temperature to equalize.
Sweating also fulfills an excretory function. Metabolic end products, alcohol, degradation products from medication and (other) toxins are transported away by the body via sweat. In this way, sweating makes an important contribution to detoxification.
Another essential function of sweat is to maintain the skin’s protective acid mantle. Sweat is acidic and has a pH value of around 4.5. Together with the skin’s own lipids, it ensures that bacteria and harmful germs cannot enter the body. As a rule, bacteria and germs cannot survive in the acidic environment of the skin.
Sweating: what is normal, what is not?
As described above, sweating is not only normal, but vital. Heavy perspiration is not unusual, especially at high outside temperatures or during physical exertion. However, there are also people who sweat uncontrollably without any recognizable external influences. If wet patches form on clothing even though it is cool or the body is at rest, this may be a sign of hyperhidrosis.
It is not always easy to distinguish pathological sweating from the normal state. If self-observation leads to the suspicion that sweating exceeds a healthy level, people should consult an expert. This is because in some – albeit rare – cases, heavy sweating can be a sign of other illnesses (e.g. an underactive thyroid). A precise medical history is therefore particularly important in order to find the appropriate treatment.
How does Botox® affect the sweat glands?
The sweat glands contain secretory cells that initiate the secretion of sweat through complex biochemical processes. Nerves lead to these secretory cells. The information for the activation of the sweat glands is therefore provided by the release of certain nerve cells or neurotransmitters. When a certain signal is received (e.g. an increased body temperature), the nerve cells send out messenger substances (the neurotransmitter acetylcholine). This messenger substance then triggers sweating at the sweat glands.
The active ingredient botulinum toxin (Botox®) is a neurotoxin. In general and aesthetic medicine, it has established itself as an effective treatment agent for various complaints. As it is only used in very highly diluted concentrations, it is largely harmless to the human organism. Botox® blocks the nerve cells so that the release of acetylcholine is inhibited. As a result, the sweat glands do not receive the stimulus to secrete sweat. As the effect of the Botox® is limited to the respective treatment area, other parts of the body can continue to sweat normally. The important functions for the body are thus still fulfilled. Only excessive sweating is reduced.
Is treatment with Botox® painful or dangerous?
During Botox® treatment, a fine cannula is used to deliver the active ingredient into the tissue. In order to reduce any unpleasant sensations during the punctures, an anesthetic cream can be applied in advance or a local anesthetic can be injected. Experience has shown that the procedure is not associated with pain.
In medicine, botulinum toxin is used in a strong dilution and in small doses. This makes it largely harmless to the body. The blockage of the nerve cells subsides after a few months. The reason for this is that the body breaks down the Botox® and therefore the effect of the treatment wears off. In specialist hands, Botox® treatment is a safe method against sweating as well as against wrinkles, bruxism (teeth grinding), headaches and other illnesses.
Duration of results and repetition of treatment
Botulinum toxin unfolds its effect gradually. After about ten days, it reaches the wrinkle treatment reaches its peak effect. The full effect of hyperhidrosis therapy usually sets in after four weeks. The body then completely breaks down the active substance within a few months. As soon as the release of the neurotransmitter is no longer prevented by the Botox®, the muscles or sweat glands can work “normally” again – in the case of hyperhidrosis, the excessive sweating may then start again. The treatment can be repeated for a lasting effect. Experience has shown that the effect of hyperhidrosis therapy with Botox® lasts for up to ten months until it slowly wears off again.
