Dermatologists are using Botox injections to treat excessive perspiration. The Food and Drug Administration approved the treatment for adult patients in 2004. Now, studies are underway to determine whether Botox is effective for teenagers.
Excessive underarm perspiration is the result of hyperactive sweat glands. Botox works by temporarily blocking the chemical signals from the nerves that stimulate sweat. In one clinical study of 322 adult patients with severe sweating, about 55 percent achieved an effective response. Eighty-four out of 104 Botox-treated patients achieved a greater than 50 percent reduction in sweating. Of those patients not treated with Botox, only 6 percent achieved an effective response.
The manufacturer of Botox, Allergan, is currently sponsoring a clinical trial of adolescents 12 to 17. The purpose is to determine whether the drug reduces underarm sweat. Heather Howlett, 16, is one participant. She reports that the treatment halted her sweating for about three months. Now, the heavy perspiration is returning. She's scheduled to receive another treatment in the coming weeks.
Sweating is the body's natural way to regulate temperature. It's common to perspire after exercising or during stressful situations.
"But for me it's always," Howlett said. "Before I had the injections, it didn't matter the temperature or if I was nervous."
Howlett says the condition is embarrassing because her classmates mistake it for poor hygiene. She wore dark sweatshirts to cover up the wet stains, and wasn't able to wear some of her favorite shirts due to the excessive sweating.
The first treatment she tried was a prescription deoderant. When this treatment didn't work, her mother took her to see dermatologist David Pariser, M.D., who is one of the investigators in the Botox study on teens. Pariser evaluated Howlett's symptoms.
"There's a physical way to directly measure the amount of sweat that's produced in the armpit by collecting it on some filter paper and weighing it" Pariser said.
The test showed that Howlett's sweat was four times heavier than average. Pariser also gave Howlett a questionare to determine how severely the excessive sweating condition was effecting her quality of life.
On the basis of these tests, Pariser diagnosed Heather Howlitt with an excessive sweating condition named Hyperhidrosis. The International Hyperhidrosis Society estimates that 176 million people have the condition. The society is creating a network of providers who treat Hyperhidrosis.
Heather Howlett's mother, Lisa, says many people in the family have the condition.
"I've learned that several of my sisters have the problem. And my mom had the same problem. But mom never talked about it," Lisa Howlett said. "We didn't know that anything could be done. There was no awareness."
Perry Solomon, M.D., is an anesthesiogist who's developed a way to administer botox treatments pain free.
"It's easy for people who don't have the condition to say it's no big deal," Solomon said. "But for people who have the condition it impacts them tremendously."
Solomon has been treating teenagers for several years. He encourages patients to decide when their symptoms are severe enough to warrant treatment. Safety concerns shouldn't scare people away.
"It's a completely local injection. It stays in the underarm or foot or wherever it's injected. It doesn't get systematically spread through the body," Solomon said.
Botox is costly. Each injection runs upwards of $600 dollars per arm. The temporary relief holds for about 3-to-6 months. Treating sweaty palms with Botox is about double the cost.