Treatment of hyperhidrosis of the underarm:

It was about the year 2000 that Botox started to be employed to treat hyperhidrosis of the underarm, but only in the past year or two has Botox treatment become known among the general public through trial and error in treatments (in the U.S.).  There are two types of sweat glands in the underarm: one type is the apocrine gland, which is mainly related to odor; and the other is the eccrine gland, which is related to sweat.  The former exists in large quantities around the hair roots, and the latter exists in slightly deeper layers and is involved in regulating body temperature (via sweating).  For this reason the eccrine gland is closely associated with the autonomic nerves.  The sympathetic nerves, in particular, control the secretion of sweat.

The symptoms of hyperhidrosis are observed with one in 100 people and involve conditions where a large and uncontrollable amount of sweat is secreted from the underarms and palms.  Generally, it is said that the amount of sweat secreted is as much as ten times greater than normal people, which adversely affects one's social life due to the staining of clothing, etc.  In the past, various treatments were attempted, for example commercially available products containing aluminum chloride, which is believed to work for hyperhidrosis.  However, the effects have been variable.  Psychological treatments are also attempted in cases where the symptoms are caused by psychological factors.  Also, if the symptoms are related to other diseases, for example obesity, menopausal syndrome, side effects of drugs (e.g. anti-psychotic agents), hormonal disorders (e.g. hypoglycemia, hypothyroidism) and neurological diseases (e.g. autonomic nerve disorder), it is of course necessary to treat the causes.

Surgical treatment techniques include the removal of sweat glands, but perfect effects cannot be obtained.  Additionally, there is a technique called sympathectomy, which destroys the sympathetic nerve nodes.  However, there is considerable difficulty in this procedure because it destroys the nerves adjacent to the spinal cord using a chest mirror, and severe side effects such as paralysis in other nerves, pupillary abnormalities called Horner syndrome and abnormal sweating in various parts of the body can occur.

In this sense, Botox could be called a breakthrough method that can control hyperhidrosis of the underarm in a period of four to six months, doing so with a high degree of safety.  Several mechanisms are considered with respect to how Botox works for hyperhidrosis.   It has been suggested that the nerve transmitter substance called acetylcholine is directly related, or that Botox influences other nerve transmitter substances at the endings of the autonomic nerves.  In any case, it is interesting that the nerve toxin called Botox would be involved even with the regulation of sweat.  Although there is little in the way of side effects, it is important to inject Botox exactly at the sweat glands, which are located between a deeper part of the skin (called the dermis) and the subdermal fat.  Otherwise the expected effects will not be obtained.  If injected too close to the surface of the skin, there is a possibility that Botox may not reach the endings of the neurons that control the sweat glands.