Excessive Sweating- Hyperhidrosis

Excessive Sweating at A Glance

  • Best Results1 treatment
  • Treatment RecoveryNil
  • Procedure Time3 minutes
  • Skin SpecialistDavin Lim
  • Duration of Results6+ months
  • AnaestheticNot required
  • Back to WorkImmediately
  • Cost$ Medicare

Excessive Sweating- Hyperhidrosis

Hyperhidrosis is the term we use for excessive sweating. It affects up to 5% of Brisbane’s population. The most frequently treated areas are the underarms or axillary hyperhidrosis, followed by the hands & feet. Medicare & the PBS provides subsidised treatments for excessive underarm sweating.

FactsFacts on Hyperhidrosis or Excessive Sweating

  • The most common areas for excessive sweating are the underarms- this is called axillary hyperhidrosis
  • Underarm sweating can be effectively treated with anti- sweat injections
  • This treatment can last up to 6 months or beyond
  • Treatments are subsidised by Medicare and the PBS and cost less than $2 a day
  • Sweaty hands can be treated with creams, iontophoresis & surgery

How common is hyperhidrosis?

Excessive sweating is very common- 3% of Brisbane’s population will have excessive underarm sweating, whilst another 2% will have sweaty hands & feet. A further 3% will have mild to moderate excessive sweating of the nose, forehead and scalp.

HH or hyperhidrosis can be genetic, one in four patients will have a family member that has excessive sweating.

Why does excessive sweating occur?

The cause of hyperhidrosis is genetic, made worse with stress, drugs & excessive caffeine intake. This type of sweating is called primary idiopathic HH or hyperhidrosis.

Primary hyperhidrosis

  • It stops in your sleep.
  • Re-commences upon awakening.
  • Often runs in families (1in 4)

Treatments are available for different forms of HH, including sweaty hands, feet, underarms, face, and scalp areas.

Stress plays a huge part in many sweat patterns. I often work in with a psychologist to help patients manage stress, and in turn break the stress-sweat-stress- sweat cycle.

How do I know if I need treatments for my excessive sweating?

If sweating bothers you get help. A good way to know the impact of excessive sweating on your life is to ask two questions-

  1. Does sweating affect your work, either at school or the work place
  2. Does sweating affect you socially- are you embarrassed about sweat marks on your shirt, or shaking hands? Does it stop you from lifting your arms above your waist? Do you always wear black?

What can be done to reduce excessive underarm sweating?

Underarm sweating can be ranked from mild thru to very severe.

Mild cases respond to over-the-counter preps at your local pharmacy. Try the following for mild cases-

  1. Over the counter antiperspirants. Rexona Sport and Dove Clinical. Next up is aluminium chloride hexahydrate. This is very strong and can cause skin irritation. Make you’re your follow the instructions on the back of the box.
  2. Botox injections. This is very effective and works in 96% of cases. Patients will receive at least 70% improvement, and some up to 100% improvement in sweating. This treatment is covered by Medicare & works out to be less than $2 a day. All injections are performed by Dr Davin Lim (me). Medicare rules means you have go to try to control your sweating before Botox, this means a trial of aluminium chloride antiperspirant, Sesderma is a good brand.
  3. Some tablets can help with underarm HH or excessive sweating. These can be prescribed by your local doctor. (Anticholinergics). Ask your GP for oxybutynin or propantheline bromide. I do not prescribe tablets for sweating as this required close follow-up & titration.
  4. Endoscopic surgery can help with sweaty hands & underarms. This procedure is performed by a vascular surgeon.
  5. miraDry is a procedure is only suited to patient who want a reduction, and not a complete stoppage of sweating. 2 treatments are needed, 2-3 months apart. Expect sweating to be reduced by 75%. I do not perform this procedure nowadays due to the high incidence of nerve damage. In my experience, endoscopic surgery is far safer with a higher success rate.

Davin’s Viewpoint on the management of excessive sweating

Hyperhidrosis is a very common condition and especially debilitating in hot humid cites like Brisbane. Fortunately most patients can be treated effectively. The Medicare and PBS rebate has changed the way we manage underarm sweating. Finally patients do not have to spend a fortune to have excellent sweat reduction. In fact, it works out to about 2 dollars a day to have sweat free underarms.

miraDry is relatively new in Australia, but I am somewhat reserved in regards to this treatment. The ideal candidate must understand that it does not work as well as anti-sweat injections, and it gives you a normal sweat pattern. miraDry permanently reduces sweating by up to 70-80%, however side effects are common. This includes long standing nerve damage, or neuropraxia.

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