Don’t Sweat It… Try Botox!

In 2004, the FDA approved the use of Botox for hyperhidrosis or severe underarm sweating.

Hyperhidrosis is a medical condition caused by over stimulated sweat glands. People with this condition often produce four to five times more sweat than people who do not suffer from hyperhidrosis.

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Hyperhidrosis triggers:

  • exercise
  • heat or cold
  • alcohol, coffee, tea, smoking , hot or spicy food
  • stress , anxiety, strong emotions

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How to diagnose Hyperhydrosis?

If there is excessive sweating of at least 6 months duration with at least two of the following characteristics then primary Hyperhydrosis is present and this can be treated with Botox.

  • Bilateral and relatively symmetrical sweating
  • Impairs daily activity
  • At least one episode per week
  • Onset before the age of 25 years
  • Positive family history
  • Cessation of sweating during sleep

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What can be done:

BOTOX®  has proven to be an effective hyperhidrosis treatment. When injected into the underarm area, BOTOX® helps to control hyperhidrosis.

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How does it work?

A small volume of BOTOX® solution is injected through a very fine gauge needle into the underarm area.  BOTOX® works by temporarily blocking the chemical signals from the nerves that stimulate the sweat glands. When these glands no longer receive the chemical signals, the excessive underarm sweating stops. The procedure takes about 5-10 minutes, is relatively painless, and the effects of the treatment have been reported to last 6-9 months (Results vary from person to person and eventually will wear off).  Depending on the severity of the hyperhidrosis, multiple injections may be needed.

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Within 1-2 weeks of the initial treatment there will be significant reduction in underarm sweating. There is a possibility that some sweat glands may be missed during BOTOX® hyperhidrosis treatment. If this occurs, underarm sweating may continue from the untreated areas and a touch-up treatment may be needed.

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How much does it cost?

For optimal results, 100 units of BOTOX® (50 units under each arm) is needed, which can run anywhere between $1000-$1500.

Pre Treatment Instructions:

  • Shave underarms 24 hours prior to procedure.
  • 2 hours before procedure avoid hot beverages or going to gym (if doing “The Starch Test”).
  • Abstain from use of over-the-counter deodorants or antiperspirants for 24 hours (if doing “The Starch Test”).
  • Do not consume a alcoholic beverages for 24 hours prior to the procedure.
  • Avoid taking Aspirin or Ibuprofen 24 hours prior to the procedure (please check with your Primary Care Physician if you take either medication on a daily basis for an existing condition)

The Starch Test:

The “Starch Test” is sometimes performed to view where the affected areas of perspiration are located.  Not all providers perform this test, as it has been said to be  unnecessary.  Most providers inject into the area of hair growth, since sweat glands lie just next to each hair follicle.

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Starch Test Info:

Patients should shave underarms and abstain from use of over-the-counter deodorants or antiperspirants for 24 hours prior to the test. Patient should be resting comfortably without exercise, hot drinks, etc for approximately 30 minutes prior to the test.

Here’s what to expect:

Iodine solution will be painted on.

Starch powder will then be sprinkled and allow to settle for 10 minutes.
A blue-black mark will identify affected area of persperation.
The area will then be circled and marked.
BOTOX® is then injected just beside each pen mark.

Post Treatment Instructions:

  • No deodorant for 12 hours
  • No heavy exercise for 24 hours
  • After Botox injections gently clean and dry your underarm using a mild soap/cleanser.
  • You may begin to experience results within 7 days, full effectiveness is achieved at 14 days.
  • Until the maximum effectiveness of the BOTOX® injection is achieved you can continue to use over the counter antiperspirants.
  • Contact your injector, if you are still experiencing sweating in the treated area after 14 days.

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Laser Hair Removal… All Questions Answered

There’s something about 7 women in a closet sized room, lasering each other’s hair off (Brazilian being one) that brings a sense of closeness.

After a fun-filled week with these amazing women, I feel compelled to write all I have learned about laser hair removal.

First and foremost, What does “LASER” mean?

Did you know the word “LASER” is an acronym which means…
Light
Amplification by
Stimulated
Emission of
Radiation

The term “radiation” is often misinterpreted because the term is also used to describe radioactive materials or ionizing radiation. The use of the word in this context, however, refers to an energy transfer. Energy moves from one location to another by conduction, convection, and radiation and cannot alter DNA structure.

How does it work?

Basically, lasers cause localized damage to the hair by selectively heating dark target matter, melanin, in the area that causes hair growth, the follicle, while not heating the rest of the skin.

 

Is every laser created equal?

No.  Different companies have different names for their lasers, but the two main lasers out there today are: Alexandrite (755) or the “Alex” & YAG (1064).  This one in particular is what I was trained on and is the latest.    It actually has both Alex and Yag in one machine!  Don’t quote me on this, but I don’t think there’s another two-in-one out there right now.  Very convenient since both are significantly different from each other.  Why?…

 Alex vs YAG… What’s the difference?

Alex (755)-

  • Attracted to melanin (treats hair and pigmented lesions)
  • Great on fair skin (skin types I – III).
  • Not recommended for skin types IV – VI.
  • No sun exposure for at least 4 weeks prior to treatment.
  • Better on thin hair.
  • Most report less discomfort than “YAG”.
  • More effective laser (usually less treatments are needed).

Here’s a perfect example of a skin type II ideal for the “Alex” laser…

YAG (1064) – 

  • Attracted to melanin and hemoglobin (treats hair, pigmented lesions, loose skin, veins, wrinkles, enlarged pores, tattoos, pseudofolliculitis barbae commonly called “ingrown hairs” or “shaving bumps”, and toe nail fungus… Yes. Fungus!)
  • Safe for every skin type (I – VI).
  • Can be used on sun exposed skin (3-4 days post).
  • Effective on thick, coarse hair.
  • Not ideal for thin textured hair.
  • Many report more discomfort during treatment than “Alex”

Definitely a “YAG” candidate in the pic below…

How many treatments are needed? 

Hair grows in several phases (anagen, telogen, catagen) and a laser can only affect the currently active growing hair follicles (anagen). This is why several sessions are needed to kill hair in all phases of growth.

The actual number of sessions depends on various parameters, including the area of the body being treated, skin color, coarseness of hair, reason for hirsutism, and gender.

Average number of treatments:
Face: 6-10 treatments every 4-6 weeks.
Body: 4-6 treatments every 8-12 weeks.

Can all hair colors be treated?

No.  Laser does not work well on light-colored hair, red hair (sorry Carrot Top), grey hair, white hair, as well as fine hair of any color, such as vellus.
Coarse dark hair on light skin is easiest to treat (ideal candidate: Snow White… or the guy below will do).

What are the most common side-effects and risks?

During treatment: discomfort.

Post treatment (most common): itching, redness, and swelling (perifollicular edema) around the treatment area. These side effects rarely last more than three days.

Unwanted side effects and risks:  hypo- or hyper-pigmentation, blistering, scarring, skin texture changes, flare of acne, swelling around the hair follicle, scab formation, purpura, infection and burning of the skin.

What areas can be treated?
If it grows hair.. Then, yes it can be treated (as long as there isn’t any underlying contraindications).

What are the contraindications?

In other words, if you have any of these conditions or are taking any of the meds listed, you CANNOT be treated?

  • Pregnant
  • Gold Therapy (If you don’t know what this is, then you have never had it)
  • Light induced seizures
  • Anyone taking photo-sensitive meds (if you are, then you need to wait 3 weeks)
  • Accutane (need to be off for 6 months)
  • Anticoagulants
  • History of skin cancer
  • Suspicious pigmented lesions
  • Lupus
  • Herpes (pre-treat with an antiviral drug such as Valtrex… But, if active, cannot be treated until dormant again)

How do I prepare for laser hair removal?

  • No waxing, tweezing, or electrolysis for 4 weeks prior.
  • If you have fair skin (skin types I -III), no sun exposure for at least 4 weeks.
  • If you have darker skin (types IV – VI), no sun for 3-5 days.
  • No threading for 10 days
  • No self-tanner for 14 days
  • Shave the area being treated the same day or the night before
  • No make-up, lotion or deodorant should be worn on the day of your treatment
  • No topical Retin-A for 3-5 days
  • No oral Retin-A for 3 weeks
  • No Accutane for 6 months

How much does it cost?

Clearly, prices are going to vary from country to state to city to town…
Prices can range anywhere from $100 per area per treatment to $900 per area per treatment (all depends on the size of the area and amount of hair).  Yes, it can be costly, but let’s take into consideration the amount of money we all spend on razors, waxing, threading, plucking.

Are there any post-treatment instructions?

Yes!.. And please follow strictly.

  • No sun exposure for 1 week (if blistered or burned, then stay out of the sun until healed… unless you want to scar)
  • Apply cool compresses to red or swollen area.
  • No Retin A for 24 hours
  • No direct heat for 24 hours (ie: hot showers.. This is a tough one for me, since I truly love mine… but I do follow this religiously as I have learned the hard way.. hehehe)
  • It will look and feel like a sunburn… treat it like one!
  • Lastly, enjoy being HAIR-FREE!

Hugs, 

Fiona