Historically patients complaining of excessive sweating, particularly under the arms, has been both a big problem and one that has been difficult to properly treat. Historically this often would involve surgery into the armpit to try and disconnect the sweat glands from the skin and invariably they would grow back. A more aggressive approach is by carrying out a sympathectomy to the cervical sympathetic chain, which is quite a major procedure, not without risk, performed by a vascular surgeon.
For several years now, Botulinum Toxin has been used as a treatment and this effectively revolutionised excessive sweating in the armpit. It is not as good elsewhere in the body because of the discomfort caused by multiple injections required, but nevertheless, the event was often life changing for the patient being able to switch off the sweat glands completely for a period of up to about 4-6 months.
Recently, there is a new machine emerging onto the UK market called Miradry by Sientra, a well respected company from the United States, and this is a microwave device that will treat excessive sweating in the armpits. The treatment takes about an hour to do both and the result is almost complete cessation of sweating in the area.
The discussion really is around the level of sweating desired for the patient and occasionally a second treatment may be required if the sweating is not acceptable after the first treatment. The results are very impressive, the patient has swelling in the arm and some discomfort for about 5-7 days afterwards, and then after that the swelling goes down and the results really are very impressive.
I think now we really do have some very safe options for treating excessive sweating and I would certainly consider these options when seeing patients in your clinic for this condition.
David R Gateley, Consultant Plastic, Reconstructive and Aesthetic Surgeon