Palmar hyperhidrosis and botox

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Ganymede
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Joined: Wed Sep 18, 2013 12:57 pm
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by Ganymede on Wed Sep 18, 2013 1:39 pm

Palmar hyperhidrosis and botox

I have generalised HH but have a big problem with my hands in particular - for obvious reasons. I can no longer have radial nerve blocks, but feel too much pain when EMLA is used. Are there any other pain relief treatments out there for the botox procedure to relieve pain?

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Dr Jonathan Bowling
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Joined: Fri May 11, 2012 11:21 am
Location: Oxford & London
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by Dr Jonathan Bowling on Wed Sep 18, 2013 5:43 pm

Re: Palmar hyperhidrosis and botox

Dear Ganymede,

If other topical anaesthetics are not helping it might be worthwhile trying 'pliaglis', a novel topical anaesthetic, which has been used in axillary hyperhidrosis. However I have not seen any reports of its use in palmar hyperhidrosis. Discuss with the team who are providing your treatment as they may already have experience of this in other areas.

Alternativley there is a method of delivering regional anaesthesia called a 'Bier's block' which is used in the emergency department for providing anaesthesia for wrist fractures.

The team looking after you may have links with the pain relief / anaesthetic department to help find a solution for you.

Finally there is an option of sympathectomy, a surgical technique to offer a lonstanding solution. However, this would need to be fully discussed with you explaining the risks and side effects of this procedure by your team.

I hope this helps
Dr Jonathan Bowling FRCP
Consultant Dermatologist
Oxford

http://www.mydermatologist.co.uk
http://www.talkhealthpartnership.com/on ... owling.php

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Wendy Green
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Joined: Thu May 24, 2012 11:27 am
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by Wendy Green on Wed Sep 18, 2013 7:59 pm

Re: Palmar hyperhidrosis and botox

Hi Ganymede,

I can truly sympathise with you because I myself suffer from hyperhidrosis on my feet and my left hand (more about that below) and know only too well how embarrassing it is. I've suffered from it for as long as I can remember.

If the botox is so painful perhaps you might consider other treatments?

I had a sympathectomy about 20 years ago, but only for my right hand; the surgeon would only do one hand at a time because it wasn't safe to do both together, due to having to collapse a lung to remove the sympathetic nerve nodes involved in the sweating. The operation was a success!

I found it helped a lot, as I'm right handed and it meant that at least I always have one dry hand to write with etc. I didn't go back to have my left hand done, as it is quite a drastic solution; but if it's especially bad I apply Perspirex, which contains aluminium chloride, which works by forming a plug in the sweat glands. Other brands include Odaban, Sweatstop, Driclor and Anhydrol Forte.

There are other treatments available these days too - this website provides useful information http://www.hyperhidrosisuk.org

I hope this information helps you :)

Wendy
Wendy Green
Health Expert and Author

http://www.talkhealthpartnership.com/on ... _green.php

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