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Ada Regina Trindade de Almeida, MD, Esteemed Brazilian Physician, Joins the IHHS Board of Directors
The International Hyperhidrosis Society is very pleased to announce the addition of Ada Regina Trindade de Almeida, MD to our distinguished Board of Directors. Dr. Trindade is a dermatological surgeon who works at Hospital do Servidor Publico Municipal de Sao Paulo, Brazil, where she is involved in the dermatology residency program. She also operates her own clinical practice in Sao Paulo. She brings much expertise and prestige to our organization.
Dr. Trindade is a pioneer in Brazil, providing the most advanced methods of treating patients with hyperhidrosis. She has mastered the techniques of using botulinum toxin (Botox) to manage axillary and palmar hyperhidrosis.
President and founding member of the IHHS, Dee Anna Glaser, MD has known Dr. Trindade for several years and says that "she has been instrumental in helping the medical community understand nuances of botulinum toxin. Her knowledge of hyperhidrosis is as big as her compassion." Dr. Trindade has also published a comprehensive book on treating hyperhidrosis patients with Botox. If you are interested in purchasing this book, click here to let us know. It is also available at Delasco's, a dermatologic supply company.
Dr. Trindade adds a Brazilian perspective and helps us reach out to the Portuguese-speaking members of our international community at a time when we are expanding our global access. In November 2008, our French portal opened and we expect our Portuguese (Brazil) portal to be operating by early 2009, thanks to a donation of our new friends at Allergan in Brazil. (Here's a perfect example of how your donations help us create programs and services for the entire hyperhidrosis community!)
These advances help us to continue opening the global lines of communication, allowing individuals with excessive sweating the world over to access information about hyperhidrosis. Very empowering!
And not a moment too soon. Dr. Trindade says she is troubled by the lack of information in Brazil or, in some cases, the prevalence of misinformation, about treating hyperhidrosis. She says that while knowledge of the disease is increasing, there is still a lack of understanding about how to treat excessive sweating. Too often, doctors are recommending sympathectomy—or endoscopic thoracic sympathectomy (ETS)—to treat patients with hyperhidrosis.
ETS is an invasive treatment with a serious side effect: irreversible compensatory sweating. The procedure involves cutting or otherwise destroying the nerve paths associated with the overactive sweat glands.
The IHHS shares Dr. Trindade's concerns about ETS surgery and views it as an option of last resort and only for those with severe cases of palmar hyperhidrosis who have exhausted all other treatment options. The IHHS receives emails everyday from people suffering the irreversible consequences of ETS and its resulting side effects. It's important to be fully informed of the risks and possible lifelong devastating side effects of ETS and make an informed decision. We hold great hope for new treatment options becoming available in the near future that would make ETS obsolete.
Dr. Trindade says that she is now seeing patients who've had ETS surgery and are looking for help because of the resulting compensatory sweating. In her estimation, educating dermatologists and hyperhidrosis patients on ETS and its undesirable side effects will continue to be the main challenge to hyperhidrosis management in Brazil.
"Sympathectomy does not solve the problem," she says. "It only moves it to another place. And sometimes the new place may be the entire [lower half] of the body." Compounding the problem, and it's a familiar one in the hyperhidrosis community, is the fact that health insurance in Brazil does not cover less invasive, more effective treatments, like Botox injections, but does cover ETS surgery.
Dr. Trindade explains that she had been using botulinum toxin for her patients with cosmetic indications—such as acne scarring correction and facial rejunvenation--when she began to use Botox injections to treat her patients with axillary hyperhidrosis.
The results for these patients were so rewarding, Dr. Trindade says, that she turned her attention to patients with palmar hyperhidrosis. "The first patient I treated told me that "the pain he felt (even with topical anesthetic) was unforgettable. I studied and learned how to perform nerve blocks, how to control the depth of the injection, and finally, how not to use nerve blocks anymore."
Dr. Trindade and her staff were able to eliminate the nerve block with use of the ice and pressure technique, a method whereby ice is applied to the intended injection point followed immediately by application of either ice or vibration to the skin surrounding the points to reduce any discomfort associated with the Botox injection. (You can see for yourself how this is done on our web site if you click here, then select "video.")
With pain management under contol, Dr. Trindade feels there are few other drawbacks to using Botox injections to manage hyperhidrosis. The effects are temporary, though long-lasting. And, when combined with other methods of sweat management--such as using clinical-strength antiperspirants at the end of the Botox effect--it can allow a patient up to 9 months of controlled sweating, depending on the area that's treated. For people receiving treatment for palmar hyperhidrosis, the Botox effect can be half that length.
When it comes to the future of treating excessive sweating, Dr. Trindade sees positive strides being made in Brazil, but some barriers remain. The price for treatment with botulinum toxin in Brazil is still high, she notes. And it's not covered under the country's health insurance. But with the Portuguese portal opening soon, and with leaders like Dr. Trindade helping to guide the education and conversation among practitioners and patients, the future of hyperhidrosis care looks very promising.
Dr. Trindade's understanding of hyperhidrosis—the reality of living with it, understanding of the nuances of its treatments, and the hurdles that stand in front of obtaining effective care—are qualities that distinguish her work.
Her real connection to multiple cultures also gives her a deep insight that will be highly beneficial to the entire hyperhidrosis community. We are extremely fortunate to have such an advocate.
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Find a doctor who treats excessive sweating. |
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