Hyperhidrosis is a medical condition characterized by a person sweating unpredictably and excessively. This can occur even in the presence of cool temperatures or in the absence of activity. Normally, a person would expect to sweat in warm weather, when they exercise, or in situations where their metabolic rate is increased such as when an individual is nervous, angry, embarrassed, or afraid. Hyperhidrosis occurs in the absence of these triggers.
Incidence, Risk Factors, and Causes
- Sweating is a natural phenomenon the body uses to help maintain normal body temperature. Patients with hyperhidrosis appear to have overactive sweat glands leading to a uncontrollable sweating which can cause significant physical and emotional discomfort.
- Focal hyperhidrosis refers to excessive sweating that primarily affects the hands, armpits, and feet.
- Affects approximately 2% of the population.
- Appears to have a familial predisposition (runs in families).
- It is estimated that less than half of patients seek medical attention.
- Secondary hyperhidrosis is sweating that occurs as the result of another medical condition. This sweating may be all over the body or just in one area. Medical conditions that can lead to secondary hyperhidrosis include:
- Anxiety disorders
- Carcinoid syndrome
- Heart disease
- Lung disease
- Parkinson's disease
- Spinal cord injury
- Tuberculosis or infectious diseases
- Medications or substance abuse
- The primary symptom of hyperhidrosis is sweating or wetness.
- Antiperspirants. Strong anti-perspirants are frequently used to control excessive sweating. It is usually recommended that the antiperspirants contain between 10%-20% aluminum chloride hexahydrate. While deodorants do not prevent or decrease the amount of sweating, they are helpful in reducing body odor.
- Medication. There are medications such as Robinul which are used to help prevent stimulation of sweat glands. Side effects of these medications can include dizziness, dry mouth, and problems with urination.
- Iontophoresis. This is an FDA approved procedure where low voltage electricity is used to treat sweating in the hands and feet. The hands and feet are placed in water and then a gentle electrical current is passed through it with the current gradually increased until the patient feels a slight tingling sensation. Therapy lasts approximately 20 min. and requires several sessions.
- Botox. Botox, or Botulinum toxin type A is a FDA approved treatment for severe underarm sweating referred to as primary axillary hyperhidrosis. Small doses of purified Botox is injected into the underarm to temporarily block the nerves that stimulate sweating.
- Minimally Invasive Thoracic Sympathectomy. In severe cases, a minimally invasive surgical procedure referred to as a sympathectomy is recommended when all else fails. This procedure works best for patients whose primary hyperhidrosis affects their hands and face. It requires the interruption of the right and left sympathetic chains which turns off the signal that tells the body to sweat excessively.
At White Plains hospital, we have a fully staffed Thoracic Surgery Service that includes board-certified thoracic surgeons, anesthesiologists, pulmonologists, and critical care intensivists that will work with your surgeon to provide great care for you when you are recovering from your surgery.
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