Facial hyperhidrosis is the name given to the distressing problem of excessive facial sweating. It is a condition that can either be acquired or congenital (present at birth). Some people naturally sweat more when they exercise but thankfully there are treatments available to help.
Common areas on the face that tend to sweat are the hairline, forehead, upper lip, nose and nape of the neck.
How anti-wrinkle injections reduce sweating
Sweating is one of your body’s ways to reduce its’ temperature. Sweating cools down the body by evaporation which draws heat away from the body thereby reducing your temperature.
Excessive sweating (hyperhidrosis) is more common than previously thought – with 1:20 people in a recent USA study reporting symptoms1 of excessive sweating. Interestingly only half of patients with hyperhidrosis discuss their symptoms with a health care professional1 which means that there are a lot of people in the population going untreated.
Anti-wrinkle injections are an effective way of treating sweating and we are going to explain how the treatment works.
Dr Brown from Cityskin discusses how to reduce forehead sweating using anti-wrinkle treatment.
How do we sweat?
The image below shows a simplified illustration of how we sweat. When our body warms up (e.g through exercise or fever) or when we experience a ‘fight or flight’ event such as running from a dog the brain sends a signal down the nerve telling the nerve ending to release a chemical called acetylcholine (Ach).
Acetylcholine is a chemical messenger which tells the sweat glands to start producing sweat. Your body then produces sweat at the correct rate to cool the body down. When the body is back to its’ normal temperature or when you have stopped running from that dog the brain stops sending signals to release Ach and you stop sweating.
Anti-wrinkle injections can injected superficially under the skin to reduce sweating. The diagram below show what happens after anti-wrinkle injections have been injected. Note that this effect only affects a 1cm diameter around the anti-wrinkle injection point. This time when the body warms up or you experience a stressful event the brain still sends a signal down the nerve but the anti-wrinkle product blocks the release of Acetylcholine around the area that has been injected. This prevents the sweat receptors receiving the signal to release sweat and as a result you sweat less.
1. Arch Dermatol Res. 2016; 308(10): 743–749
Which areas of the body can be treated for excess sweating?
Common areas that we treat to reduce sweating include:
- Hairline and forehead sweating
- Nape of the neck
- Upper lip sweating
- Armpit sweating (axillary hyperhidrosis treatment).
Hands and feet can also be treated with anti-wrinkle injections but we do not offer this at Cityskin. For palm and foot sweating you can rent or buy an iontophoresis machine which you can use at home to reduce the symptoms of foot / hand sweating.
How to treat excessive facial sweating
Treatment for facial hyperhidrosis can be categorised as conservative and medical treatment. Conservative is changes that you make to your life to reduce symptoms
1. ‘Conservative’ treatment of facial sweating
Conservative treatments are changes that you can make to reduce your symptoms. Simple changes such as reducing chilli or spicy food intake can reduce facial sweating symptoms.
2. Medical treatment of facial sweating
Your local GP can prescribe a medication called Oxybutynin to reduce sweating. Oxybutynin is an anti-cholinergic and reduces the production of acetylcholine – an essential neurotransmitter in the production of sweat. Oxybutynin can cause a dry mouth, headaches, constipation, dry eyes and blurred vision.
Anti-wrinkle injections can be used to reduce sweating, which is discussed later in this article.
3. Surgical treatment of facial sweating
Surgical treatments are available for the treatment of underarm and hand sweating but, unfortunately, not for facial sweating.
Reducing facial, forehead and hairline sweating with anti-wrinkle injections
At Cityskin we offer anti-wrinkle injections to help with facial hyperhidrosis. The anti-wrinkle product, when injected under the skin, inhibits the release of acetylcholine at the nerve synapse. Acetylcholine is a nerve transmitter which is essential for the production of sweat and therefore sweating is reduced by anti-wrinkle injections.
Forehead sweating (hyperhidrosis) treatment
To treat forehead sweating we would recommend using anti-wrinkle treatment scattered over the whole of the forehead muscle. We would treat in a similar manner to when we reduce forehead lines with anti-wrinkle injections. To treat forehead sweating we inject between 5 and 15 units of anti-wrinkle product, depending on the degree of sweating and the strength of the muscle. When treating the forehead we have to be careful not to drop the brow height so we always recommend treating the frown at the same time.
Make sure you read our guide to forehead anti-wrinkle treatment and watch our videos on how to avoid a heavy brow after treatment.
Upper lip sweating (hyperhidrosis) treatment
Upper lip sweating can be more difficult to treat – we have to be very careful with the number of units to ensure that we reduce sweating without affecting the muscles around the mouth.
We have to be careful in our placement of the product and warn patients that the treatment can temporarily make it more difficult to say the word ‘p’ or suck on a straw.
We use 2 – 4 units to reduce upper lip sweating without this affecting the look and feel of the upper lip. Upper lip sweating treatment lasts approximately 6-8 weeks because we have only used a small amount of units.
Sweating from the hariline and nape of the neck
In the video below Dr Brown is treating a patient who sweats from the back of her neck in warmer months. Using 16 units of anti-wrinkle product spaced 1 – 1.5cm apart the patient had relief for a few months.