Some patients experience major problems with excessive sweating of the hands, armpits and feet which is called Hyperhidrosis. This can be very debilitating and socially isolating especially for young people who feel that it interferes with their confidence in carrying out daily life both at work and in social situations. Patients become self-conscious, anxious and embarrassed due to their concerns with such things as odour, wet or stained clothes and physical contact.
Causes of Hyperhidrosis
The main function of sweat glands which are located in regions of the body such as the armpits, palms of hands, soles of feet and on the forehead, is to regulate body temperature. The sweat released from the glands cools the skin and lowers body temperature. This process is controlled by the Sympathetic Nervous System.
In most cases, Hyperhidrosis has no known cause (idiopathic) and is not linked to a medical condition. There are conditions which are associated with excessive sweating (Secondary Hyperhidrosis) such as menopause, hyperthyroidism, Diabetes Mellitus, obesity and some tumours.
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Treatments of Hyperhidrosis
There are many treatments that have been undertaken to treat hyperhydrosis which include anticholinergic medication, antiperspirants (often high in aluminium), iontophoresis and botox however none of these are permanent or have high success rates. Palmar hyperhydrosis or sweating of hands, is successfully treated with the procedure of thoroscopic sympathectomy.
This is a minimally invasive procedure performed under general anaesthetic where the sympathetic nerves to the arms and hands situated in the chest are divided via a diathermy inserted through a small thoroscopic port introduced between the 2nd and 3rd ribs in the armpit. This treatment produces excellent results with a 98% chance of permanent dry hands post procedure and therefore is associated with a high rate of patient satisfaction. The major complication of this procedure is compensatory sweating where excess sweating may occur elsewhere in the body following surgery as a result of removing the arms as a source of sweating and temperature regulation. It is important to discuss the procedure and its risks carefully with the patient prior to any surgical intervention.