Abstract

Objectives: There is a new demand for new BTX treatments. Patients, and mostly male patients, come for treating back part of the neck with Botulinum toxin type A for excessive sweat in the neck region and collar stains. This problem has a huge impact, not only regarding aesthetics (especially if we consider male businessmen) but also on self-esteem and self-confidence. It has a negative impact on their professional and social life, on their emotional and mental health. Because collar stains are more visible than armpits marks, which they are well aware, more patients are seeking that type of treatment. Introduction: Sweat is produced by sweat glands and sweating is a normal body process that helps regulate body temperature. Hyperhidrosis is a disorder of excessive sweating that typically affects axillae, palms, soles and face. But it also can affect back of the neck, producing noticeable collar stains which have an impact on the quality of life and are associated with physical, psychosocial, and occupational impairments. This can lead to lower self-confidence, anxiety, depression and bigger financial expenses due to clothes selection and cleaning this type of stains. Materials / method: Before injecting BTX, we did a test where we applied 3.5% iodine in alcohol solution tot he skin and then sprinkled the starch flour to show the affected area, which was 15cm x 5cm. The skin was then cleaned and the patient had anaesthetic cream put on the back of his neck, occluded, and left for 20minutes. 50IU of Botulinum toxin type A was diluted with 2ml of sterile saline. After disinfecting the skin, we did multiple intradermal injections making small papules containing Botulinum toxin. One papula contained 2IU of BTX. Results: After 5 days after injecting 50IU Botulinum toxin type A into the back part of the neck, the patient stopped to produce sweat in that area. There was a significant reduction of sweat for up to 95% which also lead to a significant reduction of marks and stains on the clothes. The effect lasted for 5 months and then sweat glands started gradually producing sweat again which lead to visible stains on the shirt collar. Conclusion: The conclusion is that intradermal injections of Botulinum toxin A are a safe and effective treatment for treating excessive sweat in the neck area and are indications for patients who have neck hyperhidrosis or trouble with collar stains which in the end helps patients to gain more confidence and improves their quality of life and wellbeing.