Hyperhidrosis is excessive perspiration, which is more than what is required to regulate body temperature. It can affect the whole body, but the armpits and palms of the hand are commonly seen in our practice. Men and women are equally affected and the majority of those affected have primary hyperhidrosis, which is thought to be caused by an overactive sympathetic nerve.
Patients commonly complain of clammy hands and excessive sweating in the armpits, which cause embarrassment or social problems.
Management
Antiperspirants containing high concentrations of Aluminium Chloride can be used to treat axillary, palmar and plantar hyperhidrosis.
Multiple injections of Botox is currently used in the treatment of axillary hyperhidrosis with good effect. It needs to be repeated once to twice a year as the effect wears off over 6-12 months.
Endoscopic thoracic sympathectomy, a surgical procedure that involves burning, clamping or cutting the nerve under camera guidance is the treatment of choice for palmar hyperhydrosis. This reduces the stimulation of the sympathetic nerve resulting in less sweating. Compensatory hyperhidrosis in another body area is a relatively common side effect of this procedure. Careful counselling of all patients by the specialist should be undertaken prior to undergoing this type of procedure.
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