HYPERHIDROSIS (SWEATY PALMS)

 

Introduction

Hyperhidrosis is a common condition in which a person sweats excessively.
 

The sweating may affect the whole of your body, or it may only affect certain areas. Commonly affected areas include the:

•armpits

•palms of your hands

•soles of your feet

•face and chest

•groin

Both sides of the body are usually affected equally – for example, both feet and both hands.

 

The sweating doesn't usually pose a serious threat to your health, but it can be embarrassing and distressing. It can also have a negative impact on your quality of life and may lead to feelings of depression and anxiety.

 What is excessive sweating?

 

There are no guidelines to determine what "normal" sweating is, but if you feel you sweat too much and your sweating has started to interfere with your everyday daily life, you may have hyperhidrosis.

For example, you may have hyperhidrosis if:

•you avoid physical contact, such as shaking hands, because you feel self-conscious about your sweating

•you don't take part in activities, such as dancing or exercise, for fear they will make your sweating worse

•excessive sweating is interfering with your job – for example, you have difficulty holding tools or using a computer keyboard

•you're having problems with normal daily activities, such as driving

•you're spending a significant amount of time coping with sweating – for example, frequently showering and changing your clothes

•you become socially withdrawn and self-conscious

Visit your doctor if you feel that your sweating is interfering with your daily activities, or you suddenly start sweating excessively.

Many people with hyperhidrosis are too embarrassed to seek medical help or believe that nothing can be done to improve it. But treatment is available.

Also visit your doctor if you are having night sweats, because it can sometimes be a sign of something more serious.

Your doctor will usually be able to diagnose hyperhidrosis based on your symptoms, although occasionally you may need blood and urine tests to check for an underlying cause (see below).

 

Who is affected

Hyperhidrosis is common. It's been estimated to affect between one and three in every 100 people.
 

Hyperhidrosis can develop at any age, although primary hyperhidrosis typically starts during childhood or soon after puberty.

What causes hyperhidrosis?

In many cases, hyperhidrosis has no obvious cause and is thought to be the result of a problem with the part of the nervous system that controls sweating. This is known as primary hyperhidrosis.

Hyperhidrosis that does have an identifiable cause is known as secondary hyperhidrosis. This can have many different triggers, including:

•pregnancy or the menopause

•anxiety

•certain medications

•low blood sugar (hypoglycaemia)

•an overactive thyroid gland (hyperthyroidism)

•infections

How hyperhidrosis is treated

Excessive sweating can be challenging to treat and it may take a while to find a treatment right for you.

Doctors usually recommend starting with the least invasive treatment first, such as powerful antiperspirants. Lifestyle changes may also help, including:

•wearing loose and light clothes

•avoiding triggers, such as alcohol and spicy foods, that could make your sweating worse

•wearing black or white clothes to help minimise the signs of sweating

 

If this doesn’t help, you may be advised to for surgery.

Hyperhidrosis is usually a long-term condition, but some people experience an improvement with time and the treatments available can often keep the problem under control.

 

urgery for hyperhidrosis (Thoracoscopic sympathectomy)

 

Although in the past this surgery was performed through large open incisions, sympathetic surgery is now routinely performed by minimally invasive methods, such as thoracoscopic sympathectomy. The patient is placed under general anesthesia and, once asleep, one or more (up to three) small (3-10 mm) incisions are made below the armpit. A telescope is then attached to a miniature video camera and the “videoscope” is passed into the chest cavity through one of these incisions. With this videoscope, the sympathetic chain can be visualized after first gently moving the lung out of the way. Through the remaining one or two incisions, instruments are placed to allow the surgeon to interrupt the chain at the specific level dictated by the patient's symptoms. Following completion of the operation, the lung is returned to its natural position and the incisions are closed. Occasionally a small tube is left inside the chest to allow evacuation of air, however, this is usually removed quickly, within hours of the surgery. After one side is completed, the surgeon then turns his/her attention to the opposite side and an identical procedure is performed.

It is considered as a small operation, and can be done as daycare procedure.

Typically, the patient remains in the hospital for a period several hours following surgery but will usually go home the same day. There is some post-operative pain following surgery and most patients will require some oral pain medication for a period of 3 to 5 days following surgery.