Controlling Hyperhidrosis

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Controlling Hyperhidrosis

 

Hyperhidrosis, excessive sweating of the hands, face, affects many

people.

 

Sweating is a physiological mechanism in which the body secrets salt

containing fluids to help dissipating heat which is produced by

exercise and hot environments. It is part of the thermal regulation

of the body. Hyperhidrosis is that clinical situation where the sweat

production is beyond the physiological need.

 

There are two main sweat glands. Eccrine and Apocrine glands. The

eccrine glands are known to be influenced by the sympathetic system.

These eccrine glands are producing the watery type of sweat. The

apocrine glands are producing more of an oily secretion of sweat. In

the armpit the two types of glands are combined creating mixed

results.

 

When it comes to excessive sweating there is dysfunction of the

sympathetic nerve chain causing excessive pathological sweating

beyond the physiological needs of the body in areas such as the

hands, feet, face, armpits, and groin.

 

The type of hyperhidrosis without a known cause is primary or

idiopathic hyperhidrosis. It generally starts during childhood,

intensifies during puberty, and persists for the rest of one's life.

There are different manifestations of hyperhidrosis, but the most

common is palmar, which affects the hands. This is the most

distressing of the types of manifestations. People with palmar

hyperhidrosis generally avoid social contact.

 

Prescription antiperspirants are the first therapeutic measure

recommended. Prescription antiperspirant alleviates some of the

sweating for a few months but is less effective offer time. It can

result in discoloration of the skin and must be repeated regularly

for life.

 

There is no specific drug to treat hyperhidrosis but sedatives and

anticholiergic drugs are sometimes used. There are many side effects

to these drugs including cotton mouth and difficulty focusing one's

eyes. Iontophoresis is a low intensity electric current applied to

the problem area immersed in an electrolyte solution. This process

has to repeated regularly in 20 minute sessions several times a week.

The results vary from many patients (70%) being happy with the

results to some being unhappy with results, expense, and the time

consuming nature of he process. Side effects include burning and

electric shock.

 

Some of the alternative treatment methods are homeopathy, massage,

acupuncture, hypnosis, radiotherapy, psychotherapy, aromatic,

meditation and herbal therapy.

 

 

The final treatment method for hyperhidrosis is surgery. The most

familiar known life long/long term help for severe cases of excessive

sweating is a medical procedure known as ETS or (Endoscopic Thoracic

Sympathectomy). Open sympathectomy was done for the last 70 years.

The endoscopic approach was developed over the last decade. E.T.S

made it possible to perform the operation on an outpatient basis with

a very high success rate (98%). The E.T.S is divided into excision of

the nerve, cutting it with electrocautery, or ultrasonic waves or

clamping the nerve. All methods are equally effective but the

clamping method gives a possibility for reversal in the instance that

the clips may be removed if compensatory sweating is too severe and

the patient can not tolerate it.

 

It is still yet to be proven that removal of the clamps will provide

total reversibility. It is a better option than the cutting method

for which the reversal procedure with a nerve graft is much more

complicated and the results are still not known. The cutting method

can be done through a one hole incision or two hole incisions between

3mm to 7mm. The clamping method has to be done through two hole

incisions. In either method the cosmetic results are much better.

 

 

Andrew Pacholyk, MS, L.Ac.

Peacefulmind.com

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