What is botulinum toxin?

Botulinum Toxin is a purified protein produced by the bacterium clostridium botulinum. It supresses sweating for up to 6 months (with wide variation between individuals) by temporarily disrupting nerve activity to muscles and sweat glands. It is commonly used in the underarm area (axilla) and can also be used to treat the palms, scalp, forehead and other areas.

Important information

Please read carefully and only sign the form if you agree to the following:-

• Contraindications: I can confirm that I do not suffer from a neuromuscular disorder, I am not taking muscle relaxants, do not have active infection and I am not pregnant or breastfeeding.
• Blood thinners: I have informed Dr Lynch if I am taking anticoagulant (blood thinning) medicine including Aspirin, Rivaroxaban, Edoxaban, Clopidogrel, Warfarin, Vitamin E or others.
• Limitations: I understand that occasionally the treatment wears off very quickly or does not work at all.
• Alternatives: I have considered alternatives to treatment including doing nothing, topical anti-perspirants, iontophoresis, tablets that suppress sweating, Miradry and surgical denervation and I have decided that at this time Botulinum toxin is the best option for me.
• Outcome: I understand that the effects take up to a week to become apparent and that with all treatments the actual degree of improvement cannot be predicted or guaranteed. I understand that the effect of treatments is temporary and needs to be repeated every 3-6 months.
• License: I am aware that treatments are “off label”, as licensed use does not cover all of the areas that are commonly treated.

Risks

Botulinum toxin injections have some important risks and it is important that you are aware of these when deciding whether the treatment is right for you.

• Increased sweating elsewhere: Reduction in sweating in one area can sometimes lead to increased sweating elsewhere.
• Specific to underarm area: Botulinum toxin can rarely cause weakness of the arms or hands.
• Specific to palms: Botulinum toxin can cause risk of weakness of the hands. As the muscles are superficial this risk is significant.
• Specific to forehead/scalp: Botulinum toxin can cause weakness of the forehead, drooping of the forehead or facial assymetry.
• Infection: There is a very small risk of bacterial or viral (e.g. herpes virus or shingles) infection.
• Injection site reaction: Any injection can cause a reaction at the site. This includes pain, inflammation, scarring, keloid scar formation, pins and needles, burning, decreased sensation / numbness, tenderness, itching, swelling, redness, haematoma, bleeding, bruising, muscle twitching, skin nodule formation, increased pigmentation, decreased pigmentation.
• General: Rarely you can have a reaction to the Botulinum toxin. This can include fainting, nausea, noises in the ear, tiredness, nasopharyngitis, bronchitis, influenza-like symptoms, blurred vision, headache.
• Allergic reaction: There is a very small risk of allergic (anaphylactic) reaction which can be serious or life threatening.

Aftercare

I am aware of the following:-

• I should not rub or massage the treated areas for at least 4 hours after treatment.
• I should avoid consuming alcohol for 24 hours after treatment.
• I should avoid exercise for 24 hours after treatment.
• I should avoid hot showers and saunas etc for 24 hours after treatment.