@ Skin Condition

HYPERHIDROSIS - Excessive Sweating

Sweating is regulated by the sympathetic nervous system. In about 1.0% of the population, this system is revved-up, over-stimulating the sweat glands causing sweating to occur at inappropriate times in specific areas of the body. This is called hyperhidrosis.

Causes

While doctors don't know why hyperhidrosis starts, they have successfully linked it to over activity in the sympathetic nervous system, which runs along the vertebra of the spine inside the chest cavity.

This chain controls the sweat glands, responsible for perspiration throughout the entire body. Depending on which part of the chain becomes overactive, different parts of the body become affected.

Sometimes people will sweat excessively because of other illnesses. These causes must first be ruled out before primary hyperhidrosis can be diagnosed.

Symptoms

Hyperhidrosis can occur in many different areas of the body, but most commonly affects the hands and feet. Palmar and planter hyperhidrosis, as they are known, are probably the most troublesome, as they are difficult for the sufferer to hide. Shaking hands becomes uncomfortable and working with paper and metals are a problem, making business and day-to-day life a struggle. Often people report that they are even embarrassed to hold the hands of those they love.

Hyperhidrosis is also common in the armpits (axillae), causing staining of clothes and, together with an embarrassing odour, forces most sufferers to change their clothes several times a day.

Facial, back and groin sweating, although less common, affect a considerable number of people.

Regardless of where it is located, hyperhidrosis presents an embarrassing problem to those afflicted with it.

Treatment

Iontophoresis

A machine called an iontophoresis machine is now available in dermatology departments in most NHS hospitals and in some private hospitals and specialist clinics.

Until about five years ago, iontophoresis was mostly carried out in physiotherapy departments and achieved varying results. However, iontophoresis is now mostly performed by specialists and, with the use of the new iontophoresis machines, the results have been quite outstanding.

Nearly all sufferers have achieved a complete cessation of sweating after about four, 20 minute sessions. The absence of sweating tends to last from about two weeks to three months. Sufferers then undergo another course of treatment, which can be practiced at home if they want to buy their own machine. For those few sufferers who do not get a complete cessation of sweating using just tap water, a drug called Glycopyrronium Bromide which is available on prescription can be added to the water. This ensures good results.

The treatment is pain free, safe, cheap to run and can be done as often as is necessary; although a treatment protocol is recommended.

Although the results are good with iontophoresis, treatment generally has to be repeated often. Weekly or fortnightly is quite normal.

Botulinum Toxin

'Botox' as it has become more widely known, is now licensed in the UK to treat axillae hyperhidrosis only. The treatment consists of a serieis of injections under the skin into the axillae. The results to date have proven to be successful. Eventually the sweating returns and a further course of treatment is needed. This treatment is available in some NHS hospitals and several private hospitals and clinics.

Surgery

In order to end hyperhidrosis, the surgeon must divide the overactive sympathetic nerves that cause the excessive perspiration. This operation is called an Endoscopic Thoracic Sympathectomy. Recovery is achieved in a short time and most people are able to return to work in week or two, depending on their individual comfort level. This is available on the NHS and privately; however, it must be noted that ?reg;compensatory sweating' is common and the risk of this must be discussed with a vascular surgeon.

Surgery is only suitable for those with palmar, axillae and facial hyperhidrosis and only when other treatments have not been successful.

Disposable axillae pads

These pads are now available to wear with clothing, under the arms, to prevent staining to clothing and to help reduce excessive perspiration showing. Contact: www.mediveinclinic.com

The Hyperhidrosis Patient Support Group is available on line for sufferers who sweat excessively. We are able to send out free information packs to all those who require them.

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