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Hyperhidrosis

Hyperhidrosis is excessive sweating and the most common, troublesome and socially awkward impact is when this is excessive underarm sweating. Botulinum toxins are a licensed, highly effective treatment for this medical problem, and options will be discussed during a consultation.

Botulinum toxins have a similar effect on the nerves to sweat glands that they do on nerves to muscles and so they are a very effective treatment for stopping the sweat glands under the armpit from working therefore stopping excessive underarm sweating.  This condition can be very awkward and embarrassing for many people and so this is a very popular and highly effective treatment option if hyperhidrosis, or excessive underarm sweating, is something that affects you.

Takes: 45 minutes

Lasts: 6-18 months

£425

  • What are polynucleotides and how do they work?
    Polynucleotides are injectable products based on fractions of (not whole) DNA derived from salmon. This is ultra-pure and very carefully manufactured and they have been used in regenerative medicine (to build tissues, cartilage) for almost 40 years. We know they are safe and we know they are effective. They work by stimulating fibroblasts which are the skin's precursors of collagen and the supportive connective tissue matrix in the skin.
  • What should I expect after treatment?
    There may be some small blebs/lumps at the sites of injection, these usually settle quickly but can take longer in some patients. Avoid make up on the area for 6 hours. DO not massage the area or have facial treatments in the area for 1 week afterwards. Results can begin as early as 7-10 days but realistically you should not expect to see improvements for 3-4 weeks - a second treatment is recommended at this stage to maximise benefit, sometimes a 3rd a few weeks later. They stimulate tissue growth so unlike fillers they do not wear off - a top up to maintain benefit is however recommended every 4-6 months as your skin continues to age so we need to continue to fight that process through regenerative boosts.
  • Are they safe and does treatment hurt
    They have been used in almost 2 million patients and with almost 40 years' of data there have been no documented serious side effects or allergies. As with all products, there are 'cheap' imitations and low grade products, and these may be associated with unreliable results and effects; at The Goldhill Clinic the products are best-in-class, with a proven safety profile and efficacy. Treatment is injection-based and the technique will vary depending on the area to be treated. There can often be a stinging discomfort during injections, but this is not always the case.
  • Are there any side effects?
    Serious side effects have not been reported. The side effects are therefore those associated with any injection - bruising, swelling, redness and discomfort at the injection site with the potential (very uncommon) for infection.
  • What should I expect after treatment?
    You can continue normal life immediately. There may be mild discomfort in the buttock, and you may feel 'wired' for a day or two but for most people there are no side effects, and any that do occur settle quickly. Treatment starts to take effect after a day or two but can take a week or more. Most people find one injection for hayfever will last them a season but occasionally people need a second treatment a few months after the first.
  • Are there any side effects?
    Steroids are immune-modulating agents and so injections for hayfever can potentially render you more prone to infections of all types. Some people feel 'wired' after an injection of steroids, with difficulty sleeping and resting - unfortunately once injected the steroid is in your system, but this side effect does tend to settle anyway if it does occur. Occasionally people have reported a large dimple at the injection site, thought to be due to loss of fatty tissue at the site of injection. This tends to be permanent. Generally people with a history of mental ill health should not have steroid injections for hayfever - significant effects on mood and mental health can occur, especially with a history of similar in the past.
  • Is it safe and does it hurt?
    It is a quick and relatively painless intramuscular injection into the buttock. Steroids have been used for hayfever injections (as well as for treating a number of other conditions) for many years so the procedure is safe and well established. This treatment is not suitable for people with active, or significant previous, mental health concerns or mood disorders.
  • How does it work?
    Hayfever injections consist of a steroid being being injected into the buttock muscle; the steroid is an anti-inflammatory, immune suppressing agent that helps suppress the symptoms of hayfever for months. Sometimes a higher dose is needed according to body weight (at a higher cost).
  • What are the side effects?
    For most people the side effects are very mild, and usually restricted to a little discomfort at the injection site, at the the time of and after the injection. More serious side effects (infection, immune reaction) are very rare. For most people, the benefits far outweigh any downsides.
  • What does treatment involve
    Vitamin B12 can be taken orally for many people or as an injection every few months into the muscle of the arm or buttock. It is a quick procedure and there is no downtime afterwards.
  • Is it safe and does it hurt?
    Vitamin B12 is given regularly to many people with a deficiency and its safety is well established. It is not recommended for those with known liver disease or very high alcohol intake/alcohol dependency. For healthy individuals the procedure is safe and not harmful, even if your levels are normal. There may be mild discomfort at the time of injection and it is not uncommon to feel some discomfort in the injected area for 24-48 hours.
  • What should I expect after treatment?
    For the vast majority you can continue normal life after treatment. Some people experience slightly prolonged discomfort or bruising or headaches, but these settle within a few days. If there are any prolonged or worrying side effects, contact your doctor immediately.
  • Does it hurt and is it safe?
    Tiny needles are used for the treatment. It is only mildly uncomfortable. Anti-wrinkle injections have been performed in aesthetics for decades (since the 1980s) and millions of treatments have been performed in that time and so we have a lot of data - serious side effects are thankfully vanishingly rare. That said, they are are prescription-only medicines in the UK and should only be administered by a prescriber (such as a doctor or nurse prescriber) and even then by someone trained to deal with any side effects that might potentially occur. There are also some restrictions on advertising the name of the medicines.
  • What should I expect after treatment?
    There is no downtime after anti-wrinkle injections. Please avoid any heavy pressure, massage, or facials for 2 weeks afterwards. It is advisable to avoid intense exercise for a few days afterwards. Results begin to appear anywhere between 3 days and a week after treatment, but you will not have the full effect until 2 weeks afterwards - please be patient as it can take up to this long for it to fully 'kick in', and some areas respond quicker than others. If at the 2 week stage you think you need a little more, please book in for a free top-up treatment.
  • How does it work?
    Anti-wrinkle injections selectively paralyse certain muscles responsible for expression or unwanted cosmetic effects. The muscle nerve supply regrows over the course of a few months and the muscle strength returns to normal unless you have a further treatment.
  • What are the side effects of anti-wrinkle injections?
    Anti-wrinkle treatments are administered via injections so the most common side effect is bruising - this is more likely if you have had aspirin or ibuprofen in the 2 weeks before treatment, or are on anticoagulants, but it can happen to anyone. Eyebrow heaviness is unfortunately a side effect that increases with time as the forehead muscles that normally lift the eyebrows are weaker anyway. Any injections into an already weakened forehead will exacerbate this problem. This will be discussed during your consultation if relevant. Occasionally the upper eyelid can become heavy after treatment for a few weeks. This is not common and again will be discussed during your consultation. Around 10-15% of people having anti-wrinkle injections for the first time have a mild immune reaction, a little like after having any travel or flu injections - mild sniffles, a headache sometimes - for 24hrs or so afterwards. The majority do not have these side effects.
  • What should I expect after treatment?
    There may be some bruising evident immediately or appearing later - it will settle. You may find you have some numbness from the anaesthetic so if it affects your mouth, take care eating and drinking (especially hot drinks) until it has resolved after an hour or so. You may have some mild swelling that can last for a few days - I usually say it is the sort only those who know you really well will notice, so it is mild and not disfiguring. Do not massage the treated area, rub it, press it for at least a week - light pressure is fine but avoid facials and heavy rubbing for at least two weeks. You can return to normal life immediately following treatment.
  • Which fillers are used?
    There are different fillers for different areas/depths/problems, but generally I use a hyaluronic acid filler from the Belotero range, or Radiesse, a brilliant standalone filler, depending on what your concern is and what I will be treating.
  • What are the side effects of fillers?
    In trained hands, fillers are generally very safe, but they are nevertheless injections and so bruising can occur after treatment. You may also find you get some swelling in the first few days afterwards. Occasionally there may be some lumpiness or uneven results, but this is usually injector dependent. Very rarely inflammatory nodules can form and infections may occur, but again these are very rare and often injector and technique dependent. There is a very rare but possible side effect of vascular occlusion with fillers - generally in experienced hands this is vanishingly rare but can still happen - this will be discussed at your consultation. In the unlikely event that this happens, treatment can be given to dissolve the filler and/or to re-establish circulation.
  • Does it hurt and is it safe?
    Most fillers now come with an anaesthetic already mixed in for comfort, and as a doctor I can use separate anaesthetic injections, creams or sprays if necessary but most people find the procedure only mildly uncomfortable. Fillers are safe products to use. There is a problem in UK law which means that anyone can call themselves an 'aesthetician' and inject fillers and consequently there is an alarmingly high rate of significant side effects - these are almost exclusively due to grossly under qualified 'aestheticians' injecting. A good question to ask: Can my injector treat any complications that might arise? Dr Ben Coyle is one of the most experienced UK aesthetic doctors and is also a prehospital emergency doctor (as well as a GP) so you really are in safe hands!
  • What is Profhilo, Hydrobooster and skinoboosters and what is the difference?
    Profhilo and hydrobooster are both brands from the same company, both of which contain ultra-pure and highly concentrated hyaluronic acid. Skinboosters is a term used to refer to other products that aim to do the same thing using hyaluronic acid of various concentrations and purity - they all aim to hydrate the skin, boosting its lustre and vibrancy. Profhilo and Hydrobooster have been shown to bio-remodel the skin's elasticity. They are used in slightly different ways in different people - your consultation will determine which, if any, is right for you.
  • What should I expect after treatment?
    With Profhilo in particular you may have some slightly tender lumps at the site of injection - these can sometimes be more obvious the next day, but settle within a few hours to a few days. All of these treatments are boosting treatments and not fillers - unlike fillers you will not see immediate results, but the hydrating, boosting, remodelling effects take around 6-8 weeks to fully show. I usually recommend a second profhilo treatment, and may recommend a second hydrobooster/skinbooster depending on results/appearances at this stage. Generally after around 6 months a further boosting treatment is advisable.
  • What are the side effects?
    As these treatments are injectable, bleeding and bruising are the commonest side effects, and some people will have mild swelling afterwards. After profile in particular you will have little lumps at the injection sites but these will settle quickly.
  • Is is safe and does it hurt?
    These contain hyaluronic acid which is a product naturally in your skin, and most fillers consist of hyaluronic acid also - it has been used for injectable treatments for years and has well established safety. Treatment can be a little uncomfortable and so anaesthetics can be used to help - injections, cream or sprays.
  • How do botulinum toxins work for migraines?
    Migraines can be treated by using botulinum toxin injections to relax the muscles around the scalp - this reduced muscle 'tension' in turn reduces the frequency and severity of migraines. It seems to work for most people and options will be discussed during your consultation.
  • Does it hurt and is it safe?
    Tiny needles are used for the treatment. It is only mildly uncomfortable. Botulinum toxins have been used in aesthetics for decades (since the 1980s) and millions of injections have been performed in that time and so we have a lot of data - serious side effects are thankfully vanishingly rare. That said, any botulinum toxin is a prescription-only medicine in the UK and should only be administered by a prescriber (such as a doctor or nurse prescriber) and even then by someone trained to deal with any side effects that might potentially occur. There are also some restrictions around advertising prescription medicines.
  • What should I expect after treatment?
    Please avoid any heavy pressure, scalp or face massage, or facials for 2 weeks afterwards. This can include visits to the hairdresser and having your head massaged during washing. It is advisable to avoid intense exercise for a few days afterwards. Results begin to appear anywhere between 3 days and a week after treatment, but you will not have the full effect until 2 weeks afterwards - please be patient as it can take up to this long for it to fully 'kick in', and some areas respond quicker than others. If at the 2 week stage you think you need a little more, please book in for an extended treatment (there is an additional cost for this).
  • What are the side effects of these treatments for migraines
    Treatment is given via injections so the most common side effect is bruising - this is more likely if you have had aspirin or ibuprofen in the 2 weeks before treatment, or are on anticoagulants, but it can happen to anyone. Eyebrow heaviness is unfortunately a side effect that increases with time as the forehead muscles that normally lift the eyebrows are weaker anyway. Any botox into an already weakened forehead will exacerbate this problem. This will be discussed during your consultation if relevant. Occasionally the upper eyelid can become heavy after treatment for a few weeks. This is not common and again will be discussed during your consultation. Around 10-15% of people having these injections for the first time have a mild immune reaction, a little like after having any travel or flu injections - mild sniffles, a headache sometimes - for 24hrs or so afterwards. The majority do not have these side effects.
  • Is it safe and does it hurt?
    It is a perfectly safe treatment. Most people find the treatment is painful and so I always recommend using an anaesthetic cream in the armpits beforehand. You can now get these numbing creams over the counter from a pharmacy, and you will need to have applied it for an hour prior to treatment, ideally with arms elevated leaving the cream in place for most of that time. Dr Ben Coyle will remove the cream during your appointment.
  • Are there any side effects?
    The treatment involves multiple injections and so a little bruising is common but it is obviously in an area that is unseen. It might be associated with some discomfort after treatment. Some people occasionally report increased sweating in other areas after treatment but I haven't observed this very often in 20 years of doing this. As with any botulinum toxin treatment, sometimes if it is your first time it is possible to have a mild immune reaction - a mild sniffle, temperature, headache for around 24 hours afterwards. Paracetamol will help, and symptoms settle quickly.
  • What does hyperhidrosis treatment involve?
    Treatment consists of multiple injections of botulinum toxin into the armpits and it is often necessary to do a test first to identify the areas of most sweating. I recommend coming for your first treatment wearing an old vest-type top that you don't mind if it gets permanently stained as the test involves iodine.
  • What should I expect after treatment?
    You can continue your life as normal after treatment but please avoid vigorous washing of the armpits and heavy exercise for a few days. It will start to work anywhere between 5 days and a week but will take two weeks for treatment to have its full effect. Once it has kicked in it usually lets around 9 months though it is not uncommon for it to last up to 18 months. You should notice significantly drier armpits afterwards and for the duration of effect.
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