RENEE MONTAGNE, host:
Some people who perspire too much and who aren't getting relief from prescription antiperspirants are turning to Botox injections for help. The Food and Drug Administration has ruled the treatment is safe and effective for adults with excessive underarm sweating. Now, dermatologists are testing Botox on teenagers with the problem.
NPR's Alison Aubrey reports.
ALLISON AUBREY reporting:
A little bit of Botox goes a long way towards reducing sweat. But the makers of the drug want to know exactly how much is needed to keep teenager's underarms dry. To figure this out, they've recruited a few hundred adolescents, 12 and up, who volunteered to have Botox injected into their armpits. The drug works by temporarily paralyzing nerves that stimulate sweat.
Sixteen-year-old Heather Howlett(ph) of Virginia signed up as soon as she heard about the study. Her most recent injection was several months ago. We reached her on her cell phone yesterday and asked her if she's still perspiring a lot.
Ms. HEATHER HOWLETT (Participant in Perspiration Study): Well, actually, right now I kind of am, because I'm in between two Botox injections.
AUBREY: Sweating is the body's natural way to cool down and regulate temperature. So if you've just taken a jog or biked across town, perspiration is obviously normal. Anxiety is another trigger.
But Heather Howlett sweats in the absence of exercise or stress.
Ms. HOWLETT: Personally, it's just kind of always. When I didn't have the injection, I was just constantly sweating. It didn't matter the temperature, whether I was nervous, if I was comfortable.
AUBREY: Heather says her classmates mistook her condition as poor hygiene, and the wet stains looked gross. To cover it up, she wore dark sweatshirts, even on warm days, and hesitated raising her hand at school.
One doctor wrote her a prescription for a heavy-duty deodorant. When that didn't work, her mother took her to see dermatologist David Pariser, who's involved in the Botox study.
Dr. DAVID PARISER (Dermatologist): There's a physical way to directly measure the amount of sweat that's produced in the armpit, and by collecting it on some filter paper and weighing it.
AUBREY: When Pariser weighed Heather Howlett's sweat, it was more than four times heavier than the average person's. Next, he asked her to answer a questionnaire.
Dr. PARISER: Patients are asked to select a score of one to four, whether their sweating never bothers them and does not affect their quality of life, whether it occasionally bothers them and sometimes affects their quality of life...
AUBREY: And so on.
Using the results of the tests, Dr. Pariser diagnosed Heather Howlett with something called hyperhidrosis, a fancy term that simply means a person sweats too much.
Heather's mother Lisa says she's thankful for the diagnosis. It turns out she herself is a heavy sweater.
Ms. LISA HOWLETT (Heather's Mother): And I've since come to learn that I have several sisters that have the same problem, and my mom has the same problem, but, I mean, you just didn't talk about it.
AUBREY: It was a generation that just adapted to the annoyance. No silk shirts or light-colored blouses. If your palms were sweaty, there were a different set of tricks, such as keeping a cold can of soda in your hand to mask the perspiration.
Dr. PERRY SOLOMON (Anesthesiologist): For people who don't have the problem, it's extremely easy to say, it's no big deal, don't, you know, you can live with it. But people who have this problem, it impacts them tremendously socially.
AUBREY: Perry Soloman is an anesthesiologist who's developed a way to administer Botox treatments pain free. Although the drug is still considered investigational for teens, he's been treating them for several years.
Dr. SOLOMON: Just think if you were a 16-year-old boy or girl and you went on a date, and you couldn't hold your date's hand, you couldn't dance, because you're afraid of touching them and putting a stain on their clothes. Or someone holds their hand and goes, ooh, that's disgusting. You know, why's your hand so wet?
AUBREY: It's unclear how many teens fit this category. Some doctors who treat hyperhidrosis say a person's sweating should be at least four times heavier than average before they're treated. Other providers, such as Dr. Solomon, say the decision about when to treat should be up to the patient, particularly since studies show Botox is safe, he says.
Dr. SOLOMON: It's a completely local injection. It stays directly in the underarm or the hand or the foot. It doesn't get systemically spread. It doesn't go anywhere else in the body.
AUBREY: The medicalization of a condition that was once considered embarrassing yet harmless does come at a price. The cost of each Botox treatment runs upwards of $600 per arm. And the relief is temporary. If money weren't an issue, mother Lisa Howlett says she'd get the injections regularly. But for now, her 16-year-old daughter Heather will most likely max out the family Botox budget.
Allison Aubrey, NPR News, Washington.
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