Hyperhidrosis (excessive sweating of the body) affects about 3% of the population. It typically affects the hands (palmar hyperhidrosis), feet (plantar hyperhidrosis), armpits (axillary hyperhidrosis) and face. This condition most often begins in puberty and causes discomfort that is at times similar to a disability. People affected by this condition feel powerless and often ashamed.
Hyperhidrosis is associated with hyperactivity of the sympathetic nervous system. Secretion of sweat by the sweat glands is regulated by the nervous system. Sweating can be triggered by stress, fear, nervousness and any strong emotions.
Causes can range from relatively benign conditions (anxiety, withdrawal, intoxication, excess weight, fever) to more serious ones, such as cancer (leukemia, lymphoma) or an endocrine disorder (diabetes, hyperthyroidism).
What are the treatments for hyperhidrosis?
The first-line treatment consists of blocking the pores by using antiperspirant products that contain alcohol or metallic salts (typically aluminum) on the affected areas. There are two other strategies to reduce excessive sweating. Botulinum toxin (Botox) injections can be administered in the armpits, hands and feet. Iontophoresis uses a low-intensity electrical current. The hands or feet are placed into two plastic pans. Electrodes covered by a protective grid are placed at the bottom of these plastic pans.
When should surgery be considered for hyperhidrosis?
Surgery is reserved for the most extreme forms of treatment-resistant hyperhidrosis of the hands and armpits. In addition to the removal of sweat glands in the armpits, there is a specific procedure for excessive hand sweating: thoracic sympathectomy. This operation involves cutting the sympathetic chain that stimulates the sweat glands, and is performed under general anesthesia. This procedure is effective, but results in a relatively frequent complication called compensatory sweating. Sweating may then migrate to other places on the body such as the chest, back or buttocks.