Hyperhidrosis

Hyperhidrosis is a condition leading to excessive sweating.  This can occur anywhere on the body but is most commonly found on the palms and armpit.  Hyperhidrosis is caused by an over active sympathetic nervous system which in turn can cause inappropriate and excessive sweating or cold clammy hands.  Some people with this condition can also experience vasospasm and have associated Raynaud’s Disease (see Raynaud’s section).

Although hyperhidrosis is not considered a life threatening condition, those who suffer from it experience significant embarrassment, social anxiety, and may even pose occupational hazards in those who depend on dry hands for their work.  Most patients who experience severe hyperhidrosis usually suffer in silence because few feel it’s a something that is treatable.  Moreover, many health care providers are unaware of the treatment options available.

Hyperhidrosis may also be caused by other conditions such as thyroid disorders, malignancy, or other diseases which can provoke a sympathetic nervous system response.  It is important to rule out these other disorders prior to embarking on treatment.

Treatments may include:

  • Antiperspirants. Excessive sweating may be controlled with strong antiperspirants, which plug the sweat ducts. Products containing 10% to 15% aluminum chloride hexahydrate are the first line of treatment for underarm sweating. Some patients may be prescribed a product containing a higher dose of aluminum chloride, which is applied nightly onto the affected areas.
  • Medication. Anticholinergics drugs, such as glycopyrrolate (Robinul, Robinul-Forte), help to prevent the stimulation of sweat glands.
  • Iontophoresis. This FDA-approved procedure uses electricity to temporarily turn off the sweat gland. It is most effective for sweating of the hands and feet. The hands or feet are placed into water, and then a gentle current of electricity is passed through it. The electricity is gradually increased until the patient feels a light tingling sensation. The therapy lasts about 10 to 20 minutes and requires several sessions.
  • Botox. Botulinum toxin type A (Botox) is FDA approved for the treatment of severe underarm sweating, a condition called primary axillary hyperhidrosis. Small doses of Botox are injected into the underarm region which temporarily block the nerves that stimulate sweating.
  • Endoscopic thoracic sympathectomy (ETS). In severe cases, a minimally invasive surgical procedure called a sympathectomy is performed. Using small incisions in the chest, a laparoscopic camera and access port is introduced and the sympathetic nerves are cut and clipped.  This results in a decrease in sympathetic input to the hands and armpits.  The results are very dramatic and instantaneous.

The Surgeons at EvergreenHealth Heart & Vascular Care are experienced in performing ETS.  The procedure is performed through small “keyhole” incisions.  Recovery is usually very quick and the results are immediate.  If you think you are suffering from hyperhidrosis, the doctors at EvergreenHealth Heart & Vascular Care will evaluate you and determine if you are a candidate for ETS.