Sweating – adaptive mechanism of the body, regulating body temperature, through the allocation of liquid products to the skin surface through the sweat glands. With excessive sweating in the underarms axillary hyperhidrosis talking about. This pathology significantly impairs quality of life of the patient, and therefore requires proper treatment. Recent years, a good alternative to surgical intervention consider treatment of hyperhidrosis by Botox.
The pathology is hereditary, is more often diagnosed in men. Axillary hyperhidrosis is not found in children, but is often observed in young people, at least – for the persons of senior age. In the right armpit sweating is more pronounced. Linked hyperhidrosis with over-activity of the eccrine sweat glands. Histological examination in patients with axillary HS noted that there is a clear cyst-like extensions and hyperplasia (proliferation) of the sweat glands.
Diagnosis of primary hyperhidrosis
To trigger excessive sweating may a number of diseases. In such cases, you should treat the cause of HS, and not its manifestation. Primary hyperhidrosis requires symptomatic treatment – local injection of botulinum toxin. Before diagnosing 1st GG should avoid many pathologies of somatic and neurological nature that triggers the development of secondary hyperhidrosis. For accurate diagnosis, the patient receives direction on the following studies:
- Lasting effect – it only takes one session to get rid of hyperhidrosis permanently.
- The result is safe enough, the risk of side effects is small.
- The procedure does not require General anestezirutaya.
- Quick result: the skin «dries» in the eyes during the day.
- Do not require a long rehabilitation period.
- The lack of injection marks on the skin.
When hyperhidrosis Botox quite effective: the effect of one procedure is about six months, after which the previous intensity of sweating is restored. During the injection, see local anhidrosis, or a significant reduction in sweating in the armpits. To maintain the desired effect carried out additional procedures, 2 times per year.
The mechanism of action of Botox
All types of botulinum toxins, particularly botulinum toxin type a have the same mechanism of action. Target of neurotoxins are proteins SNAP-25 (and others) that perform the transport function of the vesicles of acetylcholine, which must contact holinergiceski receptors. Destroying a transport protein, botulinum toxin stops the release of OH in the synaptic cleft. Thus, treatment of hyperhidrosis by Botox is blockade of transmission of impulses to the sweat glands. Getting no signal from the nervous system, the sweat glands in the actions pane, BTA does not secrete the sweat.
Preparation for the procedure
A few days before the procedure it is necessary to remove hair in the armpits. You should choose the soft deletion methods, not causing more irritation and inflammation on the skin. Suit gentle hair removal cream and new razor blades. To get rid of hair should not be the day before the manipulation. It is also necessary to abstain from taking alcoholic beverages and strenuous exercise.
Directly before the procedure beautician is required to conduct a test of the Minor in order to clarify the localization of the area of hyperhidrosis.
Description of the procedure
The procedure is simple to perform, takes less than 30 minutes.
The preparatory phase
Beautician determined the exact localisation of hyperhidrosis and its severity. For this purpose, a sample of the Minor: the skin is processed with alcohol, apply R-R solution and a thin layer of potato starch. The skin is painted a dark green color (even black) when you sweat. In size and color intensity of the spot and assessed the severity of sweating. To determine the square green diamond stands out localization of sweating, which usually coincides with natural hair growth in the axilla.
The remaining solution and starch are removed with alcohol. For pain relief is entered anestezirutmi gel, which is maintained for 1 hour.
Also during the procedure may require a local application of lidocaine in the form of a spray, especially for people with sensitive skin and children.
A thin needle is selected and fixed, a detachable needle may «jump out». The solution is injected intradermal. Patients marked the emergence of a small burning and itching. In the middle of the axilla, where hyperhidrosis is most pronounced, injected a large dose of the drug.
Recommendations for skin care after the procedure
To reduce the risk of bruising and smoothing of discomfort after injection of botulinum toxin should cool the area where it was injected.
The patient must be under the supervision of medical personnel within an hour after the performed manipulations.
Within 1-1. 5 weeks, the patient is NOT recommended:
- use deodorants and antiperspirants;
- expose themselves to significant physical loads;
- to take alcohol;
- visit the baths, solariums, saunas;
- to injure the treated area and massage it.
The action of the drug increases gradually, so do not worry if the sweating has decreased slightly. The final results are only evaluated after 14 days.
Evaluation of the results
Injection of botulinum toxin begins to act very quickly, within a few days. The estimated result of the treatment 2 weeks with the help of a familiar patient samples Minor.
When using the introduction marked a more lasting effect than intramuscular due to a slower reinnervation of sweat glands compared to muscle.
- the redness and swelling;
- pain, accompanied by burning (sometimes itching);
- local mikrogematomy;
- General weakness and lethargy;
- violation of the sensitivity of the treated area.
Also, when injection is not intradermal, and in the deeper layers to be muscle weakness.
There are 2 groups of contraindications: absolute and relative.
Group of contraindications in the treatment of axillary HS injections of BTA
Absolute contraindications 1. Pregnancy and breast-feeding. 2. Hemophilia. 3. Acute inflammatory processes. 4. Neuro-muscular disorders. 5. Hypersensitivity to the active substance and other components of the drug. Relative contraindications 1. The tendency to allergic reactions. 2. The tendency to form keloids. 3. A high degree of myopia. 4. Epilepsy. 5. Angle-closure glaucoma. 6. Abuse sertim. 7. Febrile and subfebrile body temperature.
Be careful to carry out the procedure in chronic respiratory diseases, diseases of motor neurons, impairment of swallowing and breathing, as well as the expressed asthenic conditions and neuroses.
In addition, injection of botulinum toxin is contraindicated during the treatment of some drugs.
The medication is a relative contraindication to botulinum toxin injections
Group of drugs
Antibiotics Streptomycin, polymyxin, kanamycin, amikacin, sisomicin and so on. Muscle relaxants peripheral actions Metacin, neostigmine etc. Benzodiazepines Phenazepam, diazepam, clonazepam, temazepam, alprazolam and so on. Antiplatelet agents and anticoagulants Acetylsalicylic acid, heparin sodium.
To restore the intake of these medicines only after 14 days after the procedure.