By Jenny Bryan
If you're tired of guessing which celebrities have had Botox treatment to make them look younger, check out their armpits at awards ceremonies and premiers and see who's staying dry. Botox isn't just smoothing out the wrinkles these days, it's doing away with ugly sweat stains.
Sweaty armpits used to be something no one talked about, explains Cheshire cosmetic physician, Dr Roy Saleh, but the discovery that Botox can stop embarrassing sweating means that a growing number of people are seeking help.
'Treatments for sweating used to be based mainly on deodorants and anti-perspirants,' he says. 'But we know that Botox is safe and effective, so we are able to improve the lifestyle of many of our patients with this debilitating problem.'
Dr Saleh started using it only on those with the most severe sweat problems. They were always wet under their arms and only had to think about sweating to feel it trickling down their arms.
Having seen the effects of Botox, Dr Saleh now uses it for more cosmetic sweating, for example, in people who don't want to sweat when they lecture or give presentations. But he advises against stopping all sweating.
'I tell people I'm going to try and make them normal but they need to be able to sweat a little,' he says.
why we sweat
Sweating is the body's cooling mechanism and is essential to everyday life. Across the skin are some 2-5 million eccrine sweat glands which produce thin, salty sweat. This sweat doesn't smell. But, in hairier parts, such as the armpits and groin, there are apocrine sweat glands which release stronger sweat. This contains fatty acids and other substances that bacteria like to feed on, and it is these microbes, not the sweat itself, which makes people smell if they don't wash regularly.
Everyone has a different threshold for acceptable sweating. Some are embarrassed at the faintest 'glow', while other soldier on with shirts and socks that are wringing wet. Champion sweaters lose about 10ml of fluid an hour from their armpits, and dermatologists see people whose hands get so sweaty that they cannot hold a glass of wine.
sweat busters
Zinc salts are the drying agents in most anti-perspirant deodorants. They dissolve in the sweat to form plugs which block the pores and reduce the amount of sweat that is released.
Drugs can be used to switch off sweat glands but they make other glands dry up too, for example, in the mouth.
The most desperate sweaters have had surgery to remove sweat glands or destroy the nerves that made them overactive. But results are often disappointing. Botox has the advantage that the effect is temporary. The nerve endings that are knocked out by the toxin resprout, so the effect wears off after about six months.
injecting
Botox treatment for sweating typically involves about 12 small injections to each armpit. The best sites for the injections are identified by swabbing the armpits with iodine and dusting them with powder to see which areas are sweatiest. The needle doesn't go deep, and Dr Saleh likens it to the discomfort of plucking eyebrows. The toxin blocks messages from the nerves to the sweat glands. So even if the nerves are telling the glands to release sweat, they don't respond.
In skilled hands, the injections knock out enough sweat glands to get rid of embarrassment, but leave sufficient working to ensure that normal sweating continues. Intriguingly, there is evidence to suggest that Botox reduces body odour too, but no one is quite sure why.
Dr Saleh also injects palms and fingers for those with severely sweaty hands, but he draws the line at feet. He explains that great care is needed to ensure that muscles aren't affected by the injections. Sweat-free hands aren't a lot of use if you can't move your fingers, and the potential for movement problems are even greater if feet are injected with toxin.
That's not to say that sweaty feet will always be left out in the cold. Ten years ago, neurologists who used botulinum toxin to relieve twitches and spasms dismissed the idea of using it for cosmetic reasons. A decade on, and no self-respecting cosmetic clinic would be without it.
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