Hyperhidrosis (Palmar & Plantar) Expert, Tampa, FL

What treatment do you offer for Palmar (Hands) and Plantar (Feet) Hyperhidrosis?

In addition to oral medications, topical creams, we offer Botox injections and sympathetic nerve blocks to treat hyperhidrosis.

How are Botox Injections performed?

Botox injections are performed after a nerve block (to numb the area of injection). Since palmar and plantar hyperhidrosis requires 100 injections in one sitting, this makes the procedure extremely painful and at times unbearable.

Nerve blocks numb the palms and soles, so the injections are literally pain-free.

Alternatively, if you chose not to have a nerve block, nitrous oxide (laughing gas) anesthesia can be administered to help tolerate the procedure well.

Research article by Dr. Kalava 👉Kalava A, Colon BC. Ultrasound-guided median and ulnar nerve blocks in the forearm to facilitate onabotulinum toxin A injection for palmar hyperhidrosis. J Am Acad Dermatol. 2020 Oct;83(4):e277-e278

Similarly a simple tibial nerve block will be performed before Botox injections into the bottom of the feet.

What other treatments are offered?

For palmar hyperhidrosis, stellate ganglion blocks might be useful in resistant cases. In plantar hyperhidrosis, lumbar sympathetic blocks might be helpful.

Does insurance cover Botox injections?

Botox injections for palmar and plantar hyperhidrosis are considered experimental treatment despite robust evidence. Our team will be happy to assist you with pre-authorization of the procedures.

Why chose Dr. Kalava?

Our practice is the only place in Florida that offers nerve blocks prior to 100 injections of Botox. These nerve blocks are safe and allow for an easy, painless Botox injections.

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Frequently Asked Questions

Ketamine is an anesthetic medication. It is a schedule 3 dissociative anesthetic, which has shown promising antidepressant effects that are both rapid and robust. It has been safely used for years as the ideal anesthetic in hospital and medical settings. When used under medical supervision, studies have shown ketamine infusions to have significant effects in healing treatment-resistant depression. It is on the World Health Organization’s List of Essential Medicines because of its safety and efficacy for anesthesia.

More recently, ketamine has been discovered as a safe and effective treatment for depression, and randomized controlled trials have shown rapid improvement in mood as well as reduction in suicidality compared to people who receive a placebo or another drug. Ketamine has the ability to go to work right away, unlike most antidepressants, which take weeks, sometimes months, to provide relief.

Ketamine infusion therapy is an IV procedure performed in-office by Dr. Kalava. Dr. Kalava & his associates will monitor your response and level of consciousness throughout the infusion.

Please contact our office to discuss Ketamine Infusion Therapy, and see if it is right for you.

The most important factors when choosing a ketamine provider are the doctor’s experience and commitment to providing safe, compassionate care. Dr. Kalava is the nation’s leading practitioner of ketamine infusion therapy and is a recognized expert in the field of anesthesiology.

[Scientific articles on Ketamine published by Dr. Kalava: Article 1 & Article 2 ]

Every patient is unique and deserves special care. Whether determining dose, infusion duration, the number of initial infusions, or the interval between return visits, we make individual assessments and structure ketamine treatments to match each patient’s response and unique needs.

Low dose ketamine is administered by Dr. Kalava, who is a Double Board Certified, Mayo Clinic fellowship trained Anesthesiologist. Ketamine, as we know, is an anesthetic and is best administered under the constant vigilance of a qualified anesthesiologist.

Depending on the medical condition being treated, IV ketamine can be administered over 1 minute, 40 minutes, one hour, or 4 hours. The actual type of treatment will be discussed with you during your initial consultation. The number of infusions and duration of ketamine therapy varies and is individualized. An average of 6-8 treatments are required for a good clinical response.

There are a handful of studies since 2014 that show promising results in managing symptoms from PTSD after ketamine infusion. (Study 1) (Study 2)(Study 3).

Mild psychotomimetic (confusion, hallucinations) effects, increase in heart rate, blood pressure, mild headache, and nausea are possible in some patients and are usually well tolerated.