Botox for Sweaty Palms: Fail. Drinking Alcohol to Ease Hyperhidrosis Anxiety: Danger.

A sad story from a reader who tried Botox for palmar hyperhidrosis and found his sweating was worse than ever. I am quite surprised to hear about the bad results because I had heard that others had good results from Botox injections. The main complaint I have heard about Botox is that the treatment is too expensive. However, I have heard that axillary (armpit) injections are more effective than those on the hands and feet. In any case, I am not a medical expert, so please talk to your healthcare professional.

The reader's letter brings to light the all-too-common and dangerous self-treatment technique: alcohol and other drugs. I used to drink excessively in my late teens and early 20s to relieve the anxiety caused by my hyperhidrosis. Thankfully I was able to stop, but for others who have a genetic predisposition to addiction, stopping is much more difficult. In any case, self-medicating with alcohol and other drugs is NOT a good idea and is not a sustainable strategy.

His letter also underscores the problem with our healthcare system. Botox is much more profitable for physicians than treatments such as iontophoresis, which is a recommended treatment for palmar hyperhidrois, but it is so hard to find a doctor who will prescribe that treatment. The upfront investment likely costs less than a Botox treatment.

Any suggestions for this young man? Clearly, he is intelligent and has much to offer others. I would suggest going to sweathelp.org, reading up about the other treatments besides Botox and surgery, then talking to a primary care physician or dermatologist.

Love,

Tiara

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Hi Tiara,

This is my story and you may share it:

I have been living with hyperhidrosis for over ten years now. I noticed the "problem" when I was 13 years old. I was in eighth grade, sitting in math class one day, when I looked down at myself and noticed that the armpits of my T-shirt were completely soaked. Beyond embarrassing, it was so confusing to me since the classroom was comfortably cool. I began to realize that there was something wrong with me when the sweating persisted day after day, usually during a class session. I guess over the next couple of weeks or months, the sweating spread to my hands as well as my feet, making it extremely difficult to focus and take notes in my classes. Despite the fact that both my father and grandfather are surgeons, my fear of humiliation got the best of me and I never talked about my problem to anyone. At the time, I figured that I was the only person on Earth with such a condition, and that nobody would be able to treat me. I felt like such a freak, even though I had great people skills, good looks and health, and thought of myself otherwise as a pretty normal kid.

As bad as the problem was, I taught myself to just deal with it. I would only wear certain clothing, I would constantly stuff my armpits with papertowel underneath whatever I was wearing, I would keep some type of super-absorbent material in my backpack and when the sweating got really bad, I would covertly reach down into the bag and wipe my palms with whatever it was. I was pretty good at concealing the problem from everyone, despite its magnitude.

My sweating continued from that point on, with highs of profuse sweating and lows of slight dampness depending on the timeframe. It wasn't until halfway through my senior year of high school that the sweating got really out of control, particularly in my hands (or at least I focused on my hands since they could not be hidden as well as other parts of my body). I briefly saw a psychologist, but terminated therapy because my sweating seemed to increase just talking about it.

Somehow I managed to do well academically in all the schools I attended, until my junior year of college. It was then that the sweating got so bad that I just stopped showing up to my classes unless absolutely necessary. My GPA dropped dramatically and I almost did not graduate on time. In addition to taking its toll my studies, the problem affected my relationships with important people in my life. Having usually been outgoing and popular among my peers, I became reclusive and anti-social, I became estranged from most of my family members, lost several good friends, and I began to think I was destined to live a very lonely life. I dated casually, but was never able to maintain a serious relationship since I would not allow myself to get too close to others. Behind closed doors, I drank heavily and tried a multitude of recreational drugs. I felt as if I was living such a duplicitous life, which in retrospect, probably explains my interest in spy-themed movies and novels.

I got a job at a non-profit organization immediately after college (two days after graduation) to avoid having to move back home with my parents. In the last twelve months, my job has required me to do more "spotlight" work, such as giving presentations to large crowds. Being at the center of attention triggered my sweating to what felt like a dangerously high level. The first time I seriously considered suicide was the week I found out that I would be speaking at a national conference. I don’t exactly know how I made it through that speech since I drank so much beforehand to calm my nerves. Miraculously, it went very well from what I was told, but the memory is still a blur since I was secretly drunk for that 30 minutes in front of the podium.

I finally sought help the following week when I returned home from the conference. After all the research I had done, it seemed that Botox injections had a very high success rate for curing palmar hyperhidrosis. Since my health insurance covered only so little, I would have to pay mostly out of pocket. I managed to save up enough money to cover the deductible (just under $1500) to get it done at the office of a reputable plastic surgeon that specialized in hyperhidrosis. Starving myself for two weeks and paying my rent over a month late was, in my opinion, a small price for what seemed too good to be true: dry hands. After a painful 50 injections in each hand (100 shots total), I left that doctor’s office feeling as if my life was about to change for the better. Unfortunately, that s*** did absolutely nothing.

Ever since that conference this past May, my sweating is the worst it has ever been. My hands are wet even as I write this email. The sweating has also spread to other areas of my body such as my chest, stomach, and thighs. No matter where I go or what I do, whether I am riding the subway or lying in bed watching a movie, I cannot tried hypnosis. Nothing works to alleviate the problem. I’m sure most people would not know it by looking at me, but this is the most depressed and hopeless I have ever felt.

A 24 year-old man, I have always considered myself an independent and resilient individual with so much life to live. But if this sweating disorder is a problem I must live with forever, let’s just say I am not looking forward to the rest of my life.