We provide two options for BOTOX® treatments: BOTOX® Cosmetic and Medical BOTOX® for Hyperhidrosis.
What is BOTOX® Cosmetic?
BOTOX® Cosmetic is a simple, non-surgical, physician-administered treatment that can temporarily smooth moderate to severe frown lines between the brows in people from 18 to 65 years of age. BOTOX® Cosmetic may also be used to smooth forehead lines, smile lines and lip lines. It is the only treatment of its type approved by the Food and Drug Administration (FDA).
One 10-minute treatment — a few tiny injections — and within days there’s a noticeable improvement in those persistent lines between the brows, which can last up to 4 months. Results may vary.
BOTOX® Cosmetic is a purified protein produced by the Clostridium botulinum bacterium, which reduces the activity of the muscles that cause those frown lines between the brows, forehead lines, smile lines or lip line to form over time.
About four million injections with FDA-approved BOTOX® Cosmetic are given annually. There’s only one BOTOX® Cosmetic. Talk to your doctor to see if BOTOX® Cosmetic is right for you!
Why BOTOX® Cosmetic?
As the skin ages, it loses its ability to “spring back” after being pulled on by the underlying muscles. This loss of elasticity results in the wrinkles you see in the area between the eyebrows, the glabella and the area of the upper cheek, the crow’s feet area. After years of muscle activity, these wrinkles begin to stay and become more visible with time. Having these lines can cause you to look tired or aged.
Fortunately, there is BOTOX® Cosmetic. This safe, effective treatment causes relaxation in the treated muscles that allows the lines to be less noticable. The treatments give you a more rested, youthful look!
The day of your appointment: Allow time before your appointment for filling out forms and for consulting with the doctor or a member of his or her staff. If it’s your initial visit, you may first meet with your doctor personally or a staff member. Many doctors have on-staff licensed aestheticians or nurses who are trained in skin care and skin care procedures who can answer many of your questions.
You may also be asked about your expectations for treatment and if you have any allergies or any condition that wouldn’t make you a good candidate for BOTOX® Cosmetic.
Before the procedure: You’ll probably be seated in a reclining chair, much like you find in a dentist’s office. No anesthesia is required, although your doctor may choose to numb the area with a cold pack or anesthetic cream.
The procedure: Your doctor will determine where to administer the injections by examining your ability to move certain muscles in your brow area. The entire BOTOX® Cosmetic injection procedure takes approximately 10 minutes.
After the procedure: There’s no recovery time needed. You’re ready to get on with your day! You will be asked to refrain from lying down for a few hours after your treatment and to exercise the treated muscles for about the same time. This will help give you an optimal result.
Seeing results: Within days, you may notice an improvement in the moderate to severe frown lines between your brows, forehead lines, smile lines and/or lip lines that can last up to 4 months. Results may vary.
Medical BOTOX® for Hyperhidrosis
What is Excessive Underarm Sweating?
Sweating is a normal function of our body’s largest organ, the skin. The skin produces sweat when it gets signals from your brain that your body needs to cool off. Sometimes these sweat glands become too active and produce sweat when it is not needed. Excessive sweating in medical language is called Hyperhidrosis. Hyperhidrosis can affect many different areas of the body including the armpits, hands, feet and groin areas. Excessive underarm sweating is known as Primary Axillary Hyperhidrosis. When a person has Primary Axillary Hyperhidrosis, sweating significantly exceeds the body’s normal requirements for cooling.
Do I have Primary Axillary Hyperhidrosis?
Only a medical professional can diagnose Hyperhidrosis. If you feel that you sweat too much, causing problems in your day to day living, schedule an appointment so that we can evaluate your condition. We may ask you questions about your medical history, your family history, and when you first noticed your excessive underarm sweating. You also will be asked to describe how excessive sweating affects your daily activities by answering a series of questions. Once a diagnosis has been made, we will work with you to determine the appropriate treatment option for you.
So, what are possible treatment options?
Often considered the “first line” of treatment for excessive underarm sweating, both over-the-counter and prescription strength antiperspirants are available. Antiperspirants use chemicals such as aluminum chloride and other metallic salts to block the sweat ducts. The goal is to reduce the amount of sweat that reaches the skin. The down side, however, is that high concentrations of these harsh chemicals can cause skin irritation and can ruin certain clothing.
The combination of bacteria with sweat creates the lovely thing we like to call body odor. Deodorants attempt to control body odor by making the skin more acidic. Bacteria usually do not like to live in acidic conditions, but we all know how those tricky things like to become “resistant” to things we do to them. In normal conditions, deodorants and antiperspirants combined help control sweating in addition to odor.
Iontophoresis uses an electronic device that conducts mild electrical currents to a skin surface which is submerged in shallow water during the process. (do NOT try this at home without medical assistance). Each 20-40 minute treatment is initially done 3-4 times a week, and can be maintained on a once weekly basis. Although scientists and researchers are not 100% sure how this process actually works to reduce excessive sweating, (nor do we know how they came up with this crazy thing), we do know that Iontophoresis works well for palm and foot hyperhidrosis. When treating the armpits, spongy pads are soaked in water and applied to the skin, then connected to the electrical generator.
Medical BOTOX® Treatment
Medical BOTOX® is FDA-approved for excessive underarm sweating when perspiration is inadequately managed with topical agents. Medical BOTOX® is a natural purified protein produced by Allergan, Inc., of Irvine, California, and it is the most studied brand of botulinum toxin in the world. Used in more than 20 countries worldwide for Hyperhidrosis, Medical BOTOX® has been used for over a decade to treat more than 1 million patients with various other medical conditions, including spasticity and movement disorders.
That’s great, but how does Medical BOTOX® treat Hyperhidrosis?
Medical BOTOX® has the unique ability to temporarily block signals from the nervous system that is responsible for “turning on” the body’s sweat glands. It’s simple, if the glands are not able to turn on, then they can’t pump out the sweat. The best part about Medical BOTOX® is that we can select exactly where we want to turn these sweat glands off by injections in that area. The small amount of Medical BOTOX® injected does not travel very far (about 1cm in diameter), so we can be even more selective in determining exactly which areas need to be treated.
Best of all, botulinum toxin injections can be given in the office, are quick, and do not demand any restrictions in work or leisure activity (aside from certain activities on the day of the injections).
How is Medical BOTOX® for Hyperhidrosis Performed?
Once you have been diagnosed as having primary axillary hyperhidrosis and you and your medical provider have determined that you are a candidate for treatment with Medical BOTOX® you can begin. Our providers have received special training and experience with this procedure, so you should feel at ease.
If it has not already been discussed, you should let us know if you are allergic to Medical BOTOX® product or anything in the preparation for injection. You will also need to notify your provider if you have a neuromuscular disease such as amyotrophic lateral sclerosis, motor neuropathy, myasthenia gravis, or Lambert-Eaton syndrome. It is also necessary to know if you have an infection at the intended site of injection, if you are taking antibiotics or other drugs, such as curare, which may interfere with neuromuscular transmission, or you are being treated with any medications.
Prior to the procedure a topical anesthetic may be applied to ease discomfort. Because the injections are quick and are superficially placed with a very fine needle, most people do not require topical anesthetic when treating the underarms. Your provider may also choose to use the iodine starch test to determine exactly which areas contain the most overactive sweat glands. From here we will map out the specific sites we want to inject with a skin marker. Multiple injections are given based on the assessment of the area that needs to be treated.
There is a remote possibility that during the procedure some sweat glands may be missed. As a result, you may continue to experience some sweating from the untreated areas. We will set up a follow up appointment about a month after your treatment so that we can re-evaluate the sweating areas and perhaps “fill in” the gaps with additional injections.
What are the most common side effects?
In clinical studies of patients diagnosed with hyperhidrosis, the most frequently reported side effects (3% to 10% of patients) following Medical BOTOX® injections included injection-site pain and bleeding, non-underarm sweating, infection, inflammation of the throat, flu syndrome, headache, fever, neck or back pain, itching, and anxiety.
Serious adverse events rarely have been reported. If you think you are having an allergic reaction or other unusual symptoms, such as difficulty swallowing, speaking, or breathing, call your doctor or go to the closest emergency room immediately.
How long does the effect last?
You should notice a significant reduction in underarm sweating within 4 weeks of your first treatment. In one clinical study involving 322 patients with severe underarm sweating, 81% of the patients receiving botulinum toxin injections achieved a greater than 50% reduction in sweating. And, 50% of the patients had their excessive sweating relieved for at least 201 days (nearly 7 months).
As with many medical conditions, Medical BOTOX® treatments for hyperhidrosis may be an excellent treatment, but it is not a cure for the condition – we are simply treating the symptoms. Your initial symptoms will gradually return over a period of six to seventeen months. We will require you to follow-up with us in six months to re-evaluate your degree of sweating. When needed, injections can be repeated as simply as they were done the first time.
Does insurance cover the treatment?
Because hyperhidrosis is a serious medical condition – you deserve insurance coverage and reimbursement for your doctor’s visits and treatments. It is sometimes necessary to provide your insurance company with a written personal statement outlining what preventative measures have already been taken and what over-the-counter medications or products have failed. We will do our best to help you get approval from your insurance company, but you can also find help through Allergan’s BOTOX ADVANTAGE® Program and Reimbursement Hotline. Allergan also has more than a decade of experience with reimbursement for Medical BOTOX® treatment.
To find out how Medical BOTOX® is covered under your insurance plan, call the BOTOX ADVANTAGE® Reimbursement Hotline, toll-free, at 1-800-530-6680, Monday through Friday, from 8 AM to 8 PM Eastern Time. If you do not have insurance, you may qualify for the BOTOX® Patient Assistance Program Allergan provides.
What if my insurance does not cover the treatment, or I do not want to wait?
Medical BOTOX® treatment for hyperhidrosis is a relatively new treatment that, while FDA approved for the armpits, is not always reimbursed well or takes some time to obtain coverage with some insurance companies. For this reason, you may wish to pay for your treatment out-of-pocket. Additionally, off-label uses such as treatment of the hands, feet or for excessive sweating of the forehead or other areas are not usually reimbursed.
You may still have the treatment done. The staff at Dermatology and Laser Center of Charleston will review the costs of the proposed treatment with you so you can make an informed decision.