Lasers For Hyperhidrosis in Melbourne

For years, medical professionals have been utilising laser therapy to remove skin lesions, address irregularities (e.g., rosacea), as a treatment for varicose veins and to perform delicate surgical procedures (e.g., vision correction). Today, men and women who have hyperhidrosis (HH), which is a condition characterised by overactive sweat glands, are benefiting from laser treatments as well. At Chelsea Cosmetics, experienced nurse injectors address hyperhidrosis using Botox® injections and clinicians address axillary hyperhidrosis (AH), which refers to excessive underarm sweating, using the revolutionary, highly effective interstitial laser treatment known as SweatLipo.

Hyperhidrosis typically affects the underarms (i.e., axillary hyperhidrosis), the soles of the feet, palms of the hands or the face. Other areas include the inguinal folds or the scalp. Although these are the most common places excess sweating occurs, hyperhidrosis can affect sweat glands anywhere in the body.

Hyperhidrosis can cause an individual to feel anxious, self-conscious, frustrated and embarrassed. For these reasons, men and women who sweat profusely may decide not to attend family gatherings, avoid spending time with friends and refrain from creating personal relationships. Furthermore, he or she may not feel confident enough to ask about or apply for an advancement at their current place of employment.

It is possible to eliminate the signs and symptoms of hyperhidrosis. Therefore, individuals in and around Melbourne, Australia, should consider seeking treatment for this condition from an experienced professional at Chelsea Cosmetics. The results achieved during a combination interstitial laser treatment with suction curettage can greatly improve an individual’s daily life.

There are two types of Hyperhidrosis, primary and secondary.

Most people who have hyperhidrosis inherit it. The inherited form of this condition is referred to as primary hyperhidrosis.

Although rare, there are times when a medical condition or medication causes an individual’s sweat glands to overproduce perspiration. When this happens, the individual has secondary hyperhidrosis.

The symptoms of this condition include excessive, visible perspiration occurring in the same location for a period longer than six months. If someone has hyperhidrosis, this profuse sweating will not have an apparent cause.

Primary hyperhidrosis is an inherited condition, which means it is genetic. Therefore, if one blood relative has hyperhidrosis, other blood-related family members are at risk for developing the condition. Although other areas of the body can be affected, primary hyperhidrosis usually affects the underarms.

For the patient to be diagnosed with primary hyperhidrosis, he or she must also experience at least two of the following:

• The patient’s onset of hyperhidrosis must occur before he or she turns 25.
• The excessive sweating has to occur at least once every seven days.
• Profuse sweating impairs his or her ability to complete daily activities
• The patient’s excessive perspiration must be bilateral and symmetrical
• This excessive perspiration does not occur while he or she is sleeping.

An individual with secondary hyperhidrosis:

• Does not have a blood relative with hyperhidrosis.
• Experiences flu-like symptoms (e.g., fatigue, headache).
• May have a condition (e.g., hyperthyroidism, chronic pulmonary disease) or be taking a medication (insulin, niacin, Viagra) that causes secondary HH.
• Sweats excessively during sleep.
• Develops hyperhidrosis after the age of 25.
• May be pregnant.
• Has generalized sweating all over his or her body.
• May be reaching the age of menopause.

If a medical professional suspects that a patient has secondary hyperhidrosis, laboratory tests may be ordered. These tests should help determine the reason an individual is sweating profusely.

Yes, if an individual becomes nervous or feels stressed, the symptoms of his or her condition may intensify.

Botox® injections work because they block the signals from the nerves that trigger the glands to begin producing sweat. The results a clinician achieves with anti-sweating injections last from seven to 16 months. At which point the individual can return to the clinic to receive additional injections.

While Botox® injections are a great option for treating hyperhidrosis, the results are temporary. Men and women who would like a permanent solution for their HH should consider having an interstitial laser treatment (aka SweatLipo) with or without suction curettage.

Studies show treatment with an interstitial laser is a highly effective solution for individuals with primary HH who have overactive sweat glands in their underarm area. Moreover, interstitial laser treatments typically offer results, even when other modalities fail.

Two Studies Verify the Benefits of SweatLipo for Treating AH

The researchers associated with two different, yet very similar, studies that aimed to evaluate the efficacy of laser treatment for AH asked study participants to return for follow-up visits after receiving laser treatment to address severe AH.

First Study Results – 20 Participants

During their 6-month follow-up appointment, 16 of the 20 study participants who had one laser treatment to address AH, reported significant improvement. This improvement stems from a reduction in the amount of sweat produced by his or her overactive sweat glands. These patients stated that their Hyperhidrosis Disease Severity Scale (HDSS) score improved by 2 points.

At the 1-year follow-up visit, 17 of the 20 patients stated that their HDSS score improved by at least 1 point (when compared with their baseline HDSS score).

Before receiving treatment, the patients’ average baseline HDSS scores were 3.6. Three months after treatment, their average HDSS scores were 2.3, at the 6-month mark, their average HDSS scores were 1.7. A year after treatment, their average HDSS scores were 2.2.

The Second Study Results – 13 Participants

Six months after patients underwent a laser treatment for AH, they returned for a follow-up visit. At this follow-up visit, researchers found that the patients’ HDSS scores improved by a mean of 1.3. Gravimetric measurements indicate a mean reduction in sweating of 78%.

Physicians gave the improvement in sweat a rating of 71%.
The patients gave their sweat improvement a rating of 55%.

At Chelsea Cosmetics, patients receive the most innovative and effective treatments available. Nonetheless, there are other treatment options for HH. Comparing some of these additional treatment options to SweatLipo and Botox® injections provides patients with valuable information as they consider seeking HH treatment.

miraDry®

miraDry® is a non-invasive treatment that uses microwave technology to decompose the sweat glands in the underarm area. The electromagnetic energy emitted from the miraDry® handheld device creates heat, causing thermolysis. The term thermolysis refers to decomposition by heat. While eliminating the sweat glands, the device protects the topical skin and keeps it cool. Most people with AH need two or three miraDry® treatments that are spaced about three months apart. The results attained with this treatment are permanent.

miraDry® vs SweatLipo

Although miraDry® treatments are effective and offer permanent results, patients receive quicker results with SweatLipo. With SweatLipo, the majority of patients only need one treatment to achieve the same results attained with multiple miraDry® treatments. Furthermore, miraDry® treatments use electromagnetic energy to destroy sweat glands. Some patients state that treatments using electromagnetic energy are painful.

Qbrexza™ Towelettes

Qbrexza™ is a prescription anticholinergic medication that addresses AH. This medication is in the form of a towelette. Patients need to apply this medication to their underarms every day. With continued use, this treatment does reduce the amount an individual perspires. However, some patients using these towelettes develop a rash on their underarms.

Qbrexa™ vs SweatLipo and Botox® for the Treatment of Axillary Hyperhidrosis

SweatLipo provides permanent results, and the results achieved with Botox® are long-lasting (i.e., 7 to 16 months). In addition, SweatLipo and Botox® are more effective than Qbrexa™. Furthermore, with Qbrexa™, daily application is required. The individual must also obtain a prescription for these towelettes. If the patient’s insurance does not cover Qbrexa™, he or she has to continue paying for it out of pocket. With SweatLipo, once treatment is complete, overactive sweat glands are no longer an issue and individuals can move forward with their lives.

Oral Anticholinergic Medications vs SweatLipo and Botox® Injections

Oral anticholinergic medications can treat primary hyperhidrosis. However, they affect sweat glands throughout the body, not just the glands in the areas of the body where an individual is experiencing excessive sweating. As such, the sweat glands that do not overproduce sweat also become inactive. Since all an individual’s sweat glands reduce their output, this HH solution is problematic for those who spend a lot of time in the sun or in a warm environment (e.g., a kitchen). In addition, according to the Treatment of primary hyperhidrosis with oral anticholinergic medications: a systematic review, the adverse side effects associated with oral anticholinergic medication caused 11% of the participants in a study to stop taking it.

Another issue that arises when taking an oral medication for the treatment of hyperhidrosis is the need for monitoring. Since all the patient’s sweat glands have decreased production, individuals must watch for symptoms that indicate the patient is overheated. Symptoms that indicate an individual is becoming overheated include: pale skin, nausea, dizziness, weakness, muscle cramps and a headache. Furthermore, these medications require a prescription, and they must be taken daily.

During a SweatLipo treatment or a combination treatment that includes suction curettage for AH, the clinician only targets overactive sweat glands; therefore, the patient’s other sweat glands are not affected. This means the remaining glands can still help regulate the individual’s body temperature, which greatly reduces concerns related to an individual becoming too hot.

Botox® injections also target specific sweat glands and do not require a daily commitment.

Treatments for excessive sweating of the hands and feet include sympathetic denervation (aka endoscopic thoracic sympathectomy [ETS]) and iontophoresis.

The Sympathetic Denervation Treatment for HH

Sympathetic denervation is an invasive procedure. During an ETS, the surgeon finds and then clips, cuts or destroys the nerves that are causing the sweat glands to overproduce.

An Iontophoresis Treatment To Address HH

Iontophoresis is a non-invasive treatment for HH that involves delivering a mild electric current to the sweat glands. This current interrupts the signals between the nerves and overactive sweat glands, which causes the glands to temporarily stop producing sweat. Although very effective, iontophoresis treatments for hyperhidrosis are time-consuming.

A Breakdown of Treatment With Iontophoresis

During the initial phase, patients receive treatment up to five times a week. This treatment regimen may continue for up to six weeks. After the initial phase of treatment, patients must maintain their results by returning for additional iontophoresis treatments.

The amount of time between each iontophoresis maintenance treatment depends on the severity of the patient’s hyperhidrosis. Some patients must return every few weeks. If a patient neglects to return for maintenance treatment, he or she will begin experiencing HH again.

The type of treatment an individual receives depends on the location of the hyperhidrosis as well as its severity. Medical professionals use the HDDS to determine the severity of a patient’s AH. HH.

Experts usually recommend trying clinical strength, over-the-counter antiperspirants or prescription formulations before seeking a more invasive treatment for HH.

Recommended Treatment Protocol To Address Primary Hyperhidrosis in the Underarms

Mild AH

Use a Qbrexa™ towelette on the underarms once a day.
If Qbrexa™ is ineffective; the individual should consider Botox® injections.

Severe AH

Use Qbrexa™ or have an experienced nurse injector administer Botox® injections into his or her axillary sweat glands.
If Qbrexa™ and Botox® injections are ineffective separately, consider combining these treatments.

Treatment Options for All Severities of AH

If previous treatments fail to provide acceptable results, an oral anticholinergic may be an effective option.

Should the oral anticholinergic medication neglect to provide the results the patient desires, he or she should consider having several electromagnetic energy treatments (e.g., miraDry®) or a SweatLipo treatment. The results a medical professional achieves with miraDry® and SweatLipo are permanent.

The last treatment options for hyperhidrosis include local surgery and ETS. During local surgery for the treatment of AH, the surgeon removes the patient’s sweat glands.

While performing a sympathetic denervation procedure, the surgeon finds the nerves responsible for causing the excessive sweating and clips, cuts or destroys them. The results a surgeon achieves with ETS and local surgery (e.g., suction curettage) are permanent.

At Chelsea Cosmetics, an anti-sweating injection treatment session is quick. Typically, a nurse injector completes a patient’s anti-sweating injections within 30 minutes.

Treatment steps:

After cleaning and sanitising the patient’s underarm, the nurse injector uses a very fine needle to administer the OnabotulinumtoxinA. The neurotoxin is placed just beneath the skin, near one of the patient’s overactive sweat glands. During this treatment session, patients should expect to receive several injections.

Proper placement of the OnabotulinumtoxinA is vital to ensuring the targeted sweat glands remain dormant. Results can last up to 16 months.

This treatment takes approximately an hour, and the patient returns home directly following his or her SweatLipo procedure.

All patients receive local anaesthesia, which numbs the treatment area. At Chelsea Cosmetics, patient comfort is essential, therefore, to ensure SweatLipo patients remain comfortable during their treatment, they may also receive IV sedation.

Patients receiving IV sedation are unable to drive for at least 24 hours. Since for-hire transportation can be risky following sedation, patients must bring a personal driver with them on the day of their SweatLipo procedure in Melbourne, Australia.

During a SweatLipo treatment, the clinician compresses the sweat glands in the underarm by strategically transmitting a single wavelength of laser light into a targeted area.

The patient receives local anaesthesia. He or she may also receive IV sedation.

Once the patient is comfortable, the clinician sanitises the treatment area and the suction curettage portion of the treatment begins.

The clinician creates a small incision at the front edge of an underarm crease and then infuses the area with tumescent fluid. This tumescent solution consists of epinephrine and lidocaine. Epinephrine shrinks capillaries, which decreases bleeding, and lidocaine is an anaesthetic. Infusing the underarm with tumescent fluid causes it to expand and become firm, which makes it easier for the clinician to target the patient’s sweat glands.

The treatment zone is the area where the most hair follicles are because that is the section of the underarm with the highest concentration of sweat glands.

The clinician inserts the cannula directly through the incision and begins passing the cannula back and forth. Although this cannula is similar to those used during a traditional liposuction procedure, the end of the SweatLipo cannula is not blunt, it is sharp. This specially designed cannula allows the clinician to clear away the sweat glands located just beneath the skin. Once removal is complete, the laser treatment can begin.

During the laser treatment, the clinician and the patient need to wear safety glasses. These glasses protect the patient and clinician’s eyes from the laser.

The clinician inserts a 150-mm hand piece through the previously created incision. This laser is very narrow and emits energy through a side-firing fibre that is designed to deliver energy into the treatment area. The design, power, and precision of the SweatLipo laser ensures that an experienced clinician can destroy the maximum number of sweat glands possible to decrease the amount of sweat the overactive glands produce.

There are times when a patient’s AH can be treated without the addition of suction curettage. If this is the case, the clinician can begin the laser treatment right away, bypassing the steps associated with the suction curettage procedure (e.g., tumescent fluid, cannula).

The heat the laser emits helps reduce the patient’s risk of infection. In addition, the laser helps prevent bleeding by sealing off the blood vessels. Since the laser seals off the blood vessels, patients need very little time to recover, if any.

Besides addressing profuse sweating, SweatLipo also helps control bromhidrosis, which is a companion condition that is linked to HH. In addition, the laser may inadvertently reduce the amount of excess hair on an individual’s underarms.

What Is Bromhidrosis?

Bromhidrosis is the term used when referring to the foul odour that some people with HH have. This foul odour is the byproduct of bacteria. The bacteria create this foul-smelling byproduct as they metabolise the sweat. Nonetheless, once an individual with bromhidrosis receives a SweatLipo treatment and the overactive sweat glands decrease production, the number of bacteria present on the underarm skin decrease as well. Fewer bacteria metabolising the sweat reduces the amount of byproduct being created.

A Decrease in Hair Growth on the Underarm

Since hair follicles are extremely hardy, they are difficult to remove. Nonetheless, SweatLipo can help eliminate these follicles, resulting in a decrease in armpit hair.

After their SweatLipo treatment or a combination SweatLipo with suction curettage, patients can return to their usual activities right away. Additionally, since the incisions the clinician creates are so small, patients do not have to worry about scarring.

Since sweat glands do not regenerate, the results of this laser treatment for axillary hyperhidrosis are permanent.

In general, patients can expect their treated sweat glands to reduce production within the 50% to 80% range.

A certain degree of sweating while performing strenuous activities or spending time in a hot environment is expected; HH treatments are designed for individuals who experience excessive sweating, even while they are inactive. Therefore, people who sweat profusely during times of inactivity may be good candidates for a SweatLipo treatment or a combination SweatLipo with suction curettage procedure.

SweatLipo treatments have very few risks and complications are rare.
Risks associated with laser treatment for addressing AH include:

• A reaction to the local anaesthesia the patient receives during treatment.
• A negative reaction to the medication he or she receives through the IV.
• Burns from the laser. Patients can greatly reduce the likelihood of this complication by choosing an experienced clinician to perform their AH treatment.
• An unsatisfactory result.
• An infection in the treatment area.

Patients should expect to experience some temporary bruising, inflammation, numbness, skin stiffness and tenderness in the treatment areas. These side effects typically subside within two weeks of treatment.

Since each patient is unique, the clinicians at Chelsea Cosmetics take the time to create personalised treatment plans. Therefore, the only way to determine how much an individual’s laser procedure or anti-sweating injections will cost to address AH is with a consultation.

To find out if health insurance will cover a portion of their SweatLipo or combination SweatLipo suction curettage treatment, patients need to contact their insurance company.

At Chelsea Cosmetics in Melbourne, Australia, we take patient safety and comfort seriously.

Since we are dedicated to exceeding our patients’ expectations, anything less than exceptional care is unacceptable. For this reason, our clinicians are highly experienced with performing SweatLipo and suction curettage procedures. In addition, our nurse injectors frequently administer Botox to address overactive sweat glands. If you are in the Melbourne, Australia area, and you have, or think you have hyperhidrosis, make an appointment with one of the medical professionals at Chelsea Cosmetics today. Our office phone number is +61 3 8822 3472, and our Melbourne office is located at 2/114 James St, Templestowe, VIC 3106, Australia.