openforbusinessCoronavirus update: We are seeing patients via videoconsultation where it is clinically appropriate to do so to maximise the patient and staff safety. Enhanced hygiene meaures in our rooms include acrylic screens, masks, hand sanitiser, face shields and physical distancing-related changes. We are closed on Fridays. 

Nurse Beth continues to provide ear molding services face to face on Mondays and Tuesdays. Due to limited appointment availability we are only scheduling ear molding appointments for infants aged less than three months.

There are  currently restrictions on performing elective surgery in Victorian hospitals, as private hospitals are accommodating aged care residents as well as providing nursing staff for aged care residences. Due to the significant challenges faced in scheduling emergency and urgent surgery we are currently not accepting referrals for emergency or urgent hospital surgeries. We are taking bookings for all surgeries from 21 September, or as soon as the pandemic situation permits. Please note that all patients who are scheduled for elective surgery admission are required to undertake a COVID test and obtain a negative ("not infected") result prior to admission. 

Victorians are in this together and together we will get through this. Thank you for your understanding as our community works through these unprecedented times together (last updated: 10 August 2020).

Hyperhidrosis treatment

Written by Dr Jill Tomlinson on .

axillaryhyperhidrosisHyperhidrosis is the medical term for excessive sweating. Excessive sweating can have major effects on your professional or personal life. In most instances there is no medical reason for the excessive sweating, but there are effective treatments available. This treatment is most commonly used for axillary hyperhidrosis (the medical term for "excessive sweating of the armpits") and palmar hyperhidrosis ("excessive sweating of the hands").

Can you stop my palms and/or armpits from sweating?

Yes. Botulinum toxin is a very effective method of stopping excessive sweating.

How does it work?

The botulinum toxin is administed to the affected skin with multiple injections that are spaced out over 1cm areas. The treatment reduces sweating by 90% by blocking signals between the nerves and sweat glands.

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Will it work on me?

Almost certainly. Multiple medical studies have demonstrated the safety and efficacy of this treatment. Occasionally patients report that they have had ineffective treatments done elsewhere previously. It is much more likely that in these instances the treatment was not administed correctly, or that an inadequate amount of botulinum toxin was administered. It is extremely unlikely that you are “resistant” or “immune” to botulinum toxin.

How often does treatment need to be repeated?

Most patients experience results lasting 5-12 months. Longer lasting results are seen with higher doses of botulinum toxin.

Is it painful?

Discomfort can be minimised for treatment of the armpits by using combinations of ice, distraction and local anaesthetic cream. Local anaesthetic injections are not used in the armpits as the nerves supplying the area are spread out over a relatively wide area.

For injections to the hands two wrist injections are all that you will feel for a full single hand treatment. As a plastic, reconstructive and hand surgeon I am experienced in administering local anaesthetic nerve blocks. I find that using local anaesthetic provides significantly greater comfort for my hand patients than using ice or other anaesthetic or distraction methods. The hands are very sensitive and I don’t wish to put my patients through the distress of feeling 30-50 separate injections. However, please note that you will not be able to drive home from your appointment!

Is it expensive?

The cost of treatment relates to the large volumes of botulinum toxin that need to be administered for an effective treatment. Patients who experience significant problems with hyperhidrosis find this treatment a lifesaver.

Alternative therapies

female outstretched arms in rainBefore trying botulinum toxin it is advisable to try simple treatments first. Anti-perspirants that have a high aluminium content work by forming a gel plug in the duct of the sweat gland, blocking the sweat gland. Brand names of products that have a high concentration (15% or greater) include Maxim, Drysol, CertainDri, Odaban, Anhydrol Forte, Dricolor and B+Drier.

Oral medications have a high rate of intolerable side effects, including drowsiness, nausea, blurred vision, dry mouth, rapid heart beat, constipation and urinary retention.

Talcum powder can provide limited relief.

Iontophoresis is a non-invasive electronic device that temporarily blocks the sweat ducts. The device can be used every few days for a period of 20-30 minutes to alleviate the problem.

Thoracoscopic sympathectomy is a surgical procedure that can be performed to permanently address excess sweating. Information from practitioners who practice this procedure advises that it is 80% effective. It requires a general anaesthetic and can have significant side effects such as nerve damage, scarring and compensatory hyperhidrosis.

Website Disclaimer

This website is authored by Dr Jillian Tomlinson, a fully qualified plastic, reconstructive and hand surgeon who practices in Melbourne, Australia. This website aims to inform patients and health professionals about hand surgery, illness prevention and the practice philosophy of Dr Jill Tomlinson. This website's content is designed to complement, not replace, the relationship between a patient and his/her own doctor. The information is not intended to replace the advice of a health professional. This website does not host or receive funding from advertising or from the display of commercial content.