You are used to sweating after a vigorous work-out at the gym, and perhaps even after doing some rigorous housework or yard work, but just anticipating a meeting with your boss shouldn’t induce your face and scalp to break into a dripping sweat.
Even worse, meeting your girlfriend for a dinner date or going to the movies should not cause this type of debilitating and anxiety-provoking sweat from your forehead and scalp.
If that sort of extreme perspiration sounds familiar, then you are probably one of several million people with craniofacial hyperhidrosis which is the medical term used when excessive sweating occurs on the face, scalp, and neck.
What is craniofacial hyperhidrosis?
Craniofacial hyperhidrosis is the excessive sweating affecting the forehead and face. While some people find it normal, others find it to negatively affect their health-related quality of life.
There are a lot of treatments available for this condition, including oral and/or topical anticholinergics or Anti Wrinkle Injection injections.
Patients who do not respond to pharmacological therapy may benefit from endoscopic thoracic sympathectomy or one of its variations. However, such surgery is often associated with high rates of troublesome and embarrassing compensatory sweating
What causes craniofacial hyperhidrosis?
When someone sweats excessively from their face for no apparent reason it’s called craniofacial hyperhidrosis.
This type of hyperhidrosis can cause the scalp, nose, chin, and cheeks to produce more sweat than they typically should. Primary focal hyperhidrosis, a form of hyperhidrosis that has no apparent cause and affects people over a lifetime, is the most common reason that people develop excessive craniofacial sweating.
In general, hyperhidrosis affects roughly one to three percent of the population. Many hyperhidrosis experts claim that craniofacial hyperhidrosis is worse than palmoplantar (palms and feet) or axillary (underarm) hyperhidrosis. Craniofacial hyperhidrosis can cause dripping sweat from the face and scalp at rest
About 3% of the population struggles with primary focal hyperhidrosis, and of those people, around one in five will develop symptoms of facial sweating. That means that there are a lot of people with this problem! It also tends to affect men more frequently than women.
Unfortunately, craniofacial hyperhidrosis can have a negative impact on a person’s quality of life if it’s left untreated. For example, many women are unable to keep makeup on, and sufferers can become very self-conscious about their appearance.
People suffering from craniofacial hyperhidrosis may develop anxiety because the face is so integral to social interactions. Excessive facial sweating leaves people feeling self-conscious about one of their most prominent features. It’s a problem that needs to be taken seriously and treated with respect. Luckily, there are treatments available that can lessen the burden of sweat, and reduce both a person’s sweating and anxiety.
How is craniofacial hyperhidrosis treated?
The type of treatment each patient requires depends on the cause of their craniofacial sweating. For those with primary hyperhidrosis, the goal is to reduce facial sweating and manage their symptoms via treatment.
If a patient has craniofacial sweating caused by secondary hyperhidrosis, then the goal is to eliminate the underlying issue or to manage symptoms if the causative agent can’t be reversed. This is why we always encourage initial consultations before jumping to any form of treatment.
Antiperspirants, Creams, and Oral Medications
- The first line of treatment when attempting to stop facial sweating is to use topical antiperspirant creams. There are over-the-counter topical creams for hyperhidrosis that contain aluminum chloride. This substance reduces the amount of sweat eccrine glands produce.
- If this does not work, patients can move on to the use of a prescription topical cream that contains an anticholinergic, usually glycopyrrolate. According to the most recent research, glycopyrrolate cream seems to be an effective treatment for excessive facial sweating.
- If topical creams do not work, then doctors often move on to a type of oral medication called an anticholinergic. This type of medication works on the entire body to reduce sweat production by interfering with the binding ability of a neurotransmitter called acetylcholine.
There are not many studies on the efficacy of this treatment specifically for craniofacial hyperhidrosis. However, the studies that do exist show that oral medication does tend to help, but can come with side effects. The main side effect that bothered patients in the studies available was dry mouth, although others can occur.
Is Anti Wrinkle Injection effective for craniofacial hyperhidrosis?
Anti Wrinkle Injection injections are a third-line treatment for craniofacial hyperhidrosis. This means that they are used after topical therapies and oral medications have failed to help someone.
Anti Wrinkle Injection injections are used for the treatment of axillary hyperhidrosis most frequently, but they are used for facial sweating on occasion.
However, there is no current consensus on the amount and type of botulinum toxin that should be used. Issues can also occur regarding aesthetic concerns due to Melbourne Anti Wrinkle Injection causing facial asymmetry and brow ptosis (drooping).
Endoscopic Thoracic Sympathectomy
This is a type of surgery in which the nerves of the sympathetic ganglia are disconnected from eccrine sweat glands.
The sympathetic ganglia are the part of the nervous system that connects to sweat glands to the rest of the nervous system and which is responsible for the flight or fight response. When these nerves are disconnected it prevents the body from being able to sweat in a particular area of the body because they can no longer communicate with the sweat glands in that location.
This is a viable treatment option for those suffering from craniofacial hyperhidrosis. Usually, to get rid of sweating on the head and neck, a surgeon will have to work on the T2 or T3 area of the spine. The nerves can be blocked by various means including clipping, transection, ablation, and clamping.
While ETS is very effective at stopping excessive sweating of the face, it can come with some serious side effects. ETS comes with a potential complication called compensatory sweating. This is where the body sweats excessively in areas the surgery was not performed. Compensatory sweating can be so distressing that some patients decide to have the surgery reversed.
Excessive facial sweating can be an extremely burdensome form of hyperhidrosis. The good thing is that new treatments are being developed each year and many effective treatments are already available. At Skin Club, we ask that all clients have an initial consultation with our doctors so we can provide the best treatment possible.
This is where we ask about your lifestyle, medical history, and other things that may help us determine the root cause of your condition. It will also enable us to meet your expectations as we align our procedures with your needs and goals.