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When the patient is appropriately prepped, the provider first identifies the area of involvement using a test called a starch iodine test. In this test, the provider applies iodine solution to the skin areas and once it dries, he sprinkles cornstarch over it. The starch iodine combination turns a dark blue color wherever there is excessive sweat. He then administers several intradermal injections of a chemical compound into the eccrine glands in the armpits, usually botulinum toxin type A. Eccrine glands are located throughout the body at the junction of the dermis skin layer and subcutaneous fat. The provider places each injection into the nerve endings but not in the fat. He places the injections 1 to 2 cm apart to allow the chemical compound to spread throughout the entire area.
Terminology
Axillae: Armpit.
Chemodenervation: Loss of nerve supply by treating with chemicals.
Eccrine glands: Sweat glands present in human skin.
Intradermal injection: An injection administered between the layers of skin.
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Hyperhidrosis is characterized by excessive sweating that is not normally related to heat or other physical exercises. Also known as polyhidrosis or sudorrhea, the condition can affect just one specific area or the whole body.
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