Sweating in Brazil? Global Connections in a World of Isolation
Don�t you love when you are reminded that, while the world�s population is enormously varied, there is much that we share? The �international� in our name expresses one aspect of this commonality. Excessive sweating affects people the world over no matter where they live and sufferers often share many of the same feelings of isolation, discomfort, and life limitations.
The IHHS strives to bring down the barriers that excessive sweating imposes. This has mostly been possible because of the Internet, which not only helps with the flow of information but with its ability to make the world seem smaller and more connected. For people with excessive sweating, this ability to connect with an authoritative source on hyperhidrosis, as well as to other sufferers, can reduce the feelings of helplessness and isolation. (Did you know that SweatHelp.org is available in five different languages�English, Spanish, French, German, and Portuguese? It�s yet another way to increase the flow of information.)
Our �international� status compels us to continually look around the globe to check the current state of hyperhidrosis care in different countries. In the last issue of SweatSolutions, we focused on care in South Africa; in this edition we keep the focus on the Southern Hemisphere, which is in its waning days of summer, with a look at Brazil.
We asked one of the foremost practitioners of hyperhidrosis care, Ada Regina Trindade de Almeida, MD--who also happens to be Brazilian�for her thoughts on the current state of hyperhidrosis care in Brazil. Dr. Almeida has been a longtime member of the IHHS and we recently asked her for her thoughts on the current state of hyperhidrosis care in Brazil.
�The state of care for Brazilians with hyperhidrosis is, overall, improving. The introduction of Botox has done much to draw attention to the condition and treatment. People love the results from this treatment and very often return for continued treatment sessions. Cost, however, is still a limitation factor for Botox treatments. Insurance will only cover ETS for hyperhidrosis treatment. In my office, to facilitate payment for Botox treatments, we will let patients pay over time (a current practice in Brazilian stores). We also add topicals to prolong the effect until the new treatment--usually nearer to summer.�
"Of course there are a variety of topical antiperspirants and compound formulations available over the counter; all hyperhidrosis treatments should begin here. If more control is needed, we can try systemic beta blockers, liposuction curettage, botulinum toxin, or ETS. A new antiperspirant product has recently come to market that contains 20 and 25% [aluminum compound]. Some dermatologists offer iontophoresis treatment in their offices, but we do not have good Brazilian iontophoresis machines. We have to buy them from Fischer�s devices."
She continues, "Physician awareness about these two treatments is growing, but, in general, most do not know about other treatment modalities. ETS continues too widely used, so lack of awareness remains."
When asked about the barriers in front of effective hyperhidrosis treatment, Dr. Almeida suggested three areas that need improvement. �The first one is the cost. Insurance covers only treatment for ETS and this is not always the most effective therapy. The second needed improvement is to find good iontophoresis devices in Brazil; and third, is the lack of big campaign to raise awareness about hyperhidrosis in Brazil.�
Concluding her assessment, Dr. Almeida ends with a story about a recent treatment experience that pleased her: �I recently received some cases of students applying for universities. Here in Brazil, students are required to take multiple tests in several universities over a period of 2 months. This period is very stressful for them and they want to eliminate the sweat problems using botulinum toxin. What surprised me was the fact that these patients were aware of their problem, informed about botulinum toxin treatment (they had visited the IHHS website), convinced their patents to pay for the therapy, and came to the office to get this treatment. I had more than six of these cases this year, performing Botox injections for axillary and palmar hyperhidrosis during the months of November and December 2010. They and their families were very satisfied.�
Thanks in part to the efforts and care provided by Dr. Almeida, Brazilians with hyperhidrosis have great options for treatment and treatment will continue to improve. As in all countries of the world, the biggest obstacle to care continues to be providing information and education to the public and the healthcare community.
The IHHS and its community of devoted members will continue to build lines of communication around the globe. Take advantage of all the IHHS has to offer�educational resources for Teens, Adults, and healthcare providers; the Physician Finder database to find doctors who provide hyperhidrosis care; and of course, the IHHS�s website, which is always available to offer facts, hope, and the promise of a drier tomorrow.