Chemodenervation of eccrine glands; other area(s) (eg, scalp, face, neck), per day
CPT4 code
Name of the Procedure:
Chemodenervation of eccrine glands; other area(s) (e.g., scalp, face, neck), per day.
Summary
Chemodenervation of eccrine glands involves the injection of a neurotoxin, commonly botulinum toxin (Botox), into areas where there is excessive sweating. This treatment temporarily blocks the nerves responsible for stimulating the sweat glands.
Purpose
The procedure addresses hyperhidrosis, a condition where certain areas of the body, such as the face, scalp, or neck, produce an excessive amount of sweat. The goal is to reduce sweating to normal levels, thereby improving the patient's quality of life.
Indications
- Severe primary hyperhidrosis that is unresponsive to topical treatments.
- Excessive facial sweating causing social or occupational embarrassment.
- Patients with contraindications to surgical treatment for hyperhidrosis.
Preparation
- Patients should avoid blood-thinning medications (like aspirin) for a few days before the procedure, as recommended by their healthcare provider.
- No fasting is typically required.
- A thorough medical history and assessment to rule out secondary causes of hyperhidrosis.
Procedure Description
- The area to be treated is cleaned and marked.
- A fine needle is used to inject small amounts of the botulinum toxin into the skin where the sweat glands are located.
- Multiple injections are administered in a grid pattern to cover the affected area.
- The injections are relatively quick and may cause some temporary discomfort.
Tools: Fine needles, botulinum toxin solution. Anesthesia: Local anesthesia or a topical numbing cream may be applied to minimize discomfort.
Duration
The procedure typically lasts about 30 to 45 minutes, depending on the size of the area being treated.
Setting
Chemodenervation of eccrine glands is usually performed in an outpatient clinic or a doctor's office.
Personnel
- Dermatologist or specialist physician trained in botulinum toxin injections.
- Nursing staff to assist with the procedure and patient preparation.
Risks and Complications
- Common risks: Mild pain or discomfort at injection sites, bruising, temporary weakness in nearby muscles.
- Rare risks: Allergic reactions, infection at the injection site, unintended spread of the toxin causing temporary muscle weakness in other areas.
Benefits
- Reduced sweating in the treated areas, typically noticeable within a week.
- Improved comfort and quality of life.
- Effects can last 4 to 12 months before requiring re-treatment.
Recovery
- Most patients can return to normal activities immediately after the procedure.
- Avoid strenuous activity and excessive heat (like saunas) for 24 hours.
- Follow-up appointments may be scheduled to assess the effectiveness of the treatment.
Alternatives
- Topical antiperspirants containing aluminum chloride.
- Oral medications that reduce sweating.
- Surgical options like sympathectomy or excision of sweat glands.
- Each alternative has its pros and cons related to effectiveness, side effects, and invasiveness.
Patient Experience
- During the procedure, minor discomfort from the needle pricks can be expected.
- Post-procedure, there may be temporary swelling or bruising at the injection sites.
- Most patients report noticeable reduction in sweating within a few days to a week, experiencing significant relief from hyperhidrosis symptoms.