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Hyperhidrosis (Excessive Sweating)


Hyperhidrosis, or excessive sweating, is a common disorder which produces a lot of unhappiness and embarrassment. It is estimated that 2-3% of people suffer from excessive sweating of the armpit or of the palms and soles of the feet. 


Besides disrupting normal daily activities, hyperhidrosis can cause social anxiety or embarrassment. It stains clothes, and it complicates business and social interactions.


Severe cases can have serious practical consequences as well, making it hard for people who suffer from it to hold a pen, grip a steering wheel, or shake hands.


Hyperhidrosis is defined as sweating that disrupts your normal activities. Episodes usually occur at least once a week without an obvious reason.


Causes of excessive sweating


Most cases occur in people who are otherwise healthy. Heat and emotions may trigger hyperhidrosis in some, but many who suffer from hyperhidrosis sweat nearly all the time, regardless of their mood or the weather. The cause of hyperhidrosis stems from one's temperature regulation system, specifically your sweat glands. It is believed that the abnormal sweating are due to exaggerated response to emotional stimuli.


Although there are various treatment options for hyperhidrosis, it is important to rule out underlying disease that sometimes cause excessive sweating. These can be neurologic, metabolic, and other systemic diseases. 


Excessive sweating may have a genetic component, as it often runs in families.


Treatment Options for excessive sweating


Drugs


It is a prescription-strength version of aluminum salt. The aluminum salts in this preparation collect in the sweat ducts and block them. Over time, sweating may diminish to the point at which little or no further treatment is needed. This method works reasonably well for many patients whose problem is excessive underarm sweating, but it's not satisfactory for most of those with palm and sole sweating.


Iontophoresis


Iontophoresis was introduced for more than 50 years as a treatment for excessive sweating.  The procedure uses water as a medium to conduct an electric current to the skin which combats production of sweat. The current is applied typically for 10-20 minutes per session, initially with two to three sessions per week followed by a maintenance program of treatments at three-week intervals, depending upon the patient's response. The treatment is simple, safe and not painful. 


Oral medications

Some people believe various medications can help excessive sweating. However, it is common the side effects associated may be too much to bear. 


Injections


A specific muscle relaxant much in the news as a cosmetic treatment for wrinkles, has actually been used in many areas of medicine for some time, such as in the treatment of muscle spasms and certain types of headaches. Its latest medical use is for treating excessive underarm sweating.


Injection of the protein produce approximately six months of relief from sweating. The injections are uncomfortable, but use of a very small injection needle minimizes discomfort.


Now that this treatment has received FDA approval. Drawbacks of using this treatment for the palms and soles are pain and the potential side effects of temporary muscle weakness.


Surgery


Endoscopic thoracic sympathectomy refers to surgical interruption of the sympathetic nerves responsible for sweating. Sympathectomy is an operation intended to destroy part of the nerve supply to the sweat glands in the skin. 


The surgeon inserts a special endoscopic instrument into the chest between two ribs just below the armpit. The lung is briefly deflated to better visualize and destroy the nerves. Sympathectomy is both effective and risky. Even with newer endoscopic techniques, complications of the procedure can include excessive sweating in other parts of the body as well as lung and nerve problems. 

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