Top of page Botulinum toxin type A Injections Botulinum toxin type A (BOTOX®) injections are appropriate for moderate to severe hyperhidrosis sufferers. Injection with botulinum toxin type A interrupts the signal from the nerve to the sweat gland to reduce the sweating in the area that is affected. The injection is done with a very fine needle and, for treatment of the underarms, face and head, anaesthesia is often not required as the procedure is virtually painless. For treatment of the hands and feet, local anaesthesia is used to avoid injection discomfort. The percent reduction in sweating in clinical study was 83% in 95% of participants. The effect of treatment can be immediate or take up to a week, with the average duration of effect after a single treatment being 7 months; 30% of patients have effects lasting longer than a year. Your sweating will gradually return, and your own comfort will dictate when you should repeat treatment. Side effects, if they occur, are temporary. A rare reported side effect that may be perceived is increased sweating in other areas. Other side effects may include pain at the site of injection. Surgery Surgery is often a last resort for people whose lifestyles are seriously affected by hyperhidrosis, and for whom other more conventional therapies have failed. Hyperhidrosis of the hands can be treated with a procedure known as endoscopic thoracic sympathectomy, or ETS for short. In ETS, doctors cut or clip the nerves causing abnormal sweating. Surgery can often be performed on an outpatient basis, i.e., without having to remain in hospital overnight. The type of surgery usually done for underarm sweating (auxiliary hyperhidrosis) is surgical excision of auxiliary glands. In this operation the sweat glands are actually removed. Surgery can be an effective approach to managing hyperhidrosis. Some patients report relief from their symptoms immediately after the operation. Follow-ups have shown that sweating remains reduced for at least several years after surgery in many cases. Like all surgeries, there are risks. These include the possibility of infection, and/or damage to nerves in the chest area where the incision is made. In addition, some patients’ bodies “make up” for the decreased sweating in the treated area by producing more sweat in other areas of the body; this is known as compensatory sweating.
Top of page Health Care Coverage The costs of hyperhidrosis treatments may be covered by your private or public insurance. This depends on your health plan and your treatment option. Private Health Care Coverage Private health care coverage is designed to take care of the day-to-day coverage of medications and/or treatments that your public coverage does not. Private health insurance may be provided to you by your employer, your student plan, or by other members of your family, or you may purchase coverage on an individual basis. The amount of coverage of the treatment will depend on your specific insurance plan policy. You will be reimbursed either the full amount or a percentage of the full amount (usually an average of 80%) of the medication or device for your treatment. For more information, please contact your plan provider or employer. It is important to see your hyperhidrosis specialist to be diagnosed properly and assessed for the treatment that is best for you. Private coverage for the treatments listed is generally obtainable after the treatment takes place. You would submit your receipts for the medication or the device to your insurance carrier who would then make a judgment on your coverage. This process will vary depending on your insurance plan. The treatments for hyperhidrosis that are often covered by private health insurance are botulinum toxin type A, topical treatments (aluminum chloride) and lontophoresis. Private Health Care Coverage Public health care in Canada is a provincial responsibility. You will have a health care card for the province that will essentially cover all your appointments with a medical doctor in clinics and hospitals as well as some treatments, blood work, x-rays, etc. The only treatment for hyperhidrosis covered by public health care coverage in Canada is surgery. You should discuss this with your physician if this is the right treatment option for you Top of page
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