Hyperhidrosis, commonly known as excessive sweating, is a common disorder that produces multiple problems for sufferers.
It is estimated that about 2–3% of the world's population suffers from excessive sweating in the areas of the armpits, hands and feet, not to mention secondary hyperhidrosis, which affects areas that have nothing in common with the typical ones, such as:
• Head
• Face
• Trunk
• Thighs
Usually these areas are linked to dysfunctions of a different nature; however, they make life very difficult for those affected.
Typical hyperhidrosis tends to begin in late adolescence, beginning with the palm of the hands and feet. Untreated, this problem can last a lifetime.
Sweating is a daily factor that creates embarrassment, stains clothes, ruins romantic moments and complicates social interactions. In severe cases it can also have serious logistical consequences, making it difficult to hold a pen, the steering wheel of a car, or shake hands.
What is the cause of hyperhidrosis?
The causes can be:
• Neurological
• Metabolic
• Systemic
Most cases occur in people who are healthy, when it is very hot, because of strong emotions or stress, but many people sweat almost every waking hour, regardless of their mood or the weather.
What is the best treatment for hyperhidrosis?
Through a systematic assessment of the causes and triggering factors, a gradual approach of optimised treatment is followed on a case-by-case basis.
This is generally done as follows:
• Antiperspirants containing aluminium chloride
• Prescription antiperspirants containing hexahydrate aluminium chloride
• Iontophoresis, a device that passes electricity through the skin with tap water
• Anticholinergic drugs that can reduce sweating
• Surgery, a procedure called cervical sympathectomy, considered as a last resort
- Botulinum toxin, recently approved in the United States by the FDA for the treatment of excessive underarm sweating
Endoscopic thoracic sympathectomy is a procedure performed under general anaesthetic. A micro-camera is inserted into the chest under the armpits, and the nerve pathways associated with overactive sweat glands are destroyed. This procedure is permanent, there are no reversal treatments.
The main disadvantage of this procedure is that, while endoscopic thoracic sympathectomy can be effective in reducing or eliminating sweat in the typical areas (armpits, feet and hands), almost all patients have some degree of compensatory perspiration in different parts of the body.
Compensatory sweating is excessive and occurs on the back, chest, abdomen, legs, face and buttocks following surgery. The end result may be worse than the original hyperhidrosis problem
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