Hyperhidrosis is a medical condition where an individual experiences excessive sweating beyond the amount needed for the body to maintain a constant (core) temperature of 37°C. There may occasionally be an underlying medical condition causing the sweating such as but in the vast majority of cases, there is no obvious cause and this form of sweating is called Primary hyperhidrosis.

Primary Hyperhidrosis can occur in two forms, focal or generalised hyperhidrosis. In focal hyperhidrosis, excessive sweating is localised to particular areas of the body such as the hands or feet or armpits or face.  In generalised hyperhidrosis, however, most of the body is affected. Hyperhidrosis can present at any age, but is present from birth in many cases. It tends to present to the medical profession in late teenage years when social interaction starts to be affected. 

The exact cause of hyperhidrosis is not known but an abnormal function of the central sympathetic nervous system may be a factor. The sympathetic nervous system is the portion of the nervous system that controls the body’s energy and resources during stress or arousal stimuli.  Therefore, when a person with focal hyperhidrosis experiences such stimuli (e.g. excitement or fear) their sweat glands produce even more perspiration.

Dr Bond is one of the few doctors who specialise in the holistic management of hyperhidrosis and is able to advise upon and provide all possible medical and surgical treatments. It is absolutely vital to realise that there is no perfect treatment for all individuals and during a consultation with Dr Bond, he will spend considerable time discussing all the options. Some of the options for management of hyperhidrosis are listed as follows...

Avoidance Measures

Avoiding situations that are known to bring on sweating can be difficult, avoiding nylon, wearing special garments

Antiperspirants

Excessive sweating may be controlled with strong anti-perspirants, which plug the sweat ducts. Products containing 10% to 20% 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. Antiperspirants can cause skin irritation, and large doses of aluminum chloride can damage clothing. Note: Deodorants do not prevent sweating, but are helpful in reducing body odour. 

Medication

Anticholinergics drugs, such as glycopyrrolate (Robinul, Robinul-Forte), help to prevent the stimulation of sweat glands. Although effective for some patients, side effects are common and include dry mouth, dizziness, and problems with urination and sexual function

Iontophoresis

This 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 10-20 minutes and requires several sessions. Side effects include skin cracking and blisters, although rare.

Botox

Botulinum toxin type A (Botox) is FDA approved for the treatment of severe underarm sweating. Small doses of purified botulinum toxin injected into the underarm temporarily block the nerves that stimulate sweating. Side effects include injection-site pain and flu-like symptoms. If you are considering Botox for other areas of excessive sweating talk to your doctor in detail. Botox can be used for sweating of the palms, feet and other areas but can be uncomfortable in these areas.

Endoscopic thoracic sympathectomy (ETS)

In severe cases, a minimally-invasive surgical procedure called sympathectomy may be recommended when other treatments fail. The procedure turns off the signal that tells the body to sweat excessively. It is usually done on patients whose palms sweat much more heavily than normal. It may also be used to treat extreme sweating of the face. ETS does not work as well for those with excessive armpit sweating and is strongly contra indicted in people with generalised sweating.

To see a visual example of the positive effects of Thorascopic sympathectomy please visit out GALLERY.

Surgical Excision of Affected Skin

Treatment of severe hyperhidrosis by excision of sweat glands is only really feasible for axillary (under-arm) sweating but for this presentation it is a very effective method of reducing sweating. However, it is only one of several treatments available. It has both advantages and disadvantages. In particular, it is a surgical procedure involving an anaesthetic and a cut whereas there are non-surgical treatments available. You should consider carefully if it is the right procedure for you.