Excessive sweating can be greatly annoying and socially embarrassing. Sufferers need to frequently change their shirts, avoid certain colours, and are continually distracted by their sweating, concerned that others will notice.

Tiny injections of Agent B or Agent D distributed over the sweat-prone skin will produce a profound reduction in sweating if the dose is adequate. But what is the right dose?

Textbooks and journal articles on this topic have recommended doses of 50-100 units Agent B per armpit. And, no doubt, these doses are effective. However, even at our practice, a total dose of 100 units of Agent B is $1190. An expensive proposition for many.

What we have found, though, is that even lower doses can bring about great improvements in sweating rates, rendering the problem negligible or insignificant.

So, we will generally administer just 20 units of agent B to each side: a total of 40 units for $590 and the great majority of patients are very happy with the sweating reductions they then see.

(And, occasionally, a patient will need a higher dose. We will top-up the Agent B at just $10 per unit).

Palms

Whether we treat underarms or hands, multiple injections are required. Such a treatment into the palms and fingers is painful, so we have to use local anaesthetic to apply a nerve block at the wrist prior to treatment. The hand is then made numb for several hours. You won’t be able to work the rest of that day, nor should you attempt to drive home.