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Hyperhidrosis

Do you constantly wipe your hands in the daily life? Do you need to change your clothes frequently? Or are your hair is always damp and wet? How about handshaking? Do you get embarrassed to shake hands? If you suffer from these issues, you may have gotten the excessive sweating disorder called ‘hyperhidrosis’.

What is Excessive Sweating (Hyperhidrosis) ?

Sweating is a natural event that occurring for thermoregulation of the human body. Sweating occurs through sympathetic nerves in our body. Normally, 1 ml/min. sweat is secreted in each square meter of the body but this amount can be up to 40 times greater in some people. This condition is described as ‘hyperhidrosis’, i.e. excessive sweating. Excessive sweating affects about 1% of the total population.

What is Its Impact On Our Social Lives ?

Excessive sweating in the armpits, hands and feet may cause problems by adversely affecting the personal and social lives of people. With intent to overcome this wetness problem, people use hydrophilic fabrics and pads in their armpits or they need to frequently change clothes. Excessive sweating can lead to serious social problems both in personal and professional lives. Hyperhidrosis can be compared with serious diseases, in terms of the extent of its negative impact on the quality of life.

In a study carried out in the United States, 40 percent of people have reported that hyperhidrosis has affected their business life, emotional relationships, as well as their ability to meet with new people. In the same study, the feeling of being restricted was found to be 35 percent, while the lack of confidence was 50 percent, the feeling of unhappiness was 34 percent, and the feeling of being restricted in daily activities was 38 percent.

Does it Also Cause Other Physical Disorders ?

Intense sweat on the skin may cause maceration (softening of the skin resulting from prolonged exposure to wetness) and secondary microbial infections. Excessive sweating symptoms may also cause serious emotional and social problems.

What are the Classification and Causes of Excessive Sweating ?

Hyperhidrosis can be divided into two groups, as primary and secondary.

– Idiopathic (primary) hyperhidrosis

In this case, in which the disorder begins before age 25, occurs at least once per week at the both sides of the body and affects the daily activities, and some cases involving people who have family members with similar complaints, are considered to be primary, i.e. Idiopathic (disorder with an unknown cause). However, almost all the cases of hyperhidrosis that create problems in the social lives of people are hyperhidrosis cases with an unknown cause, i.e. idiopathic (primary). It mostly affects the palms, soles or axillary region.

– Secondary hyperhidrosis

It is more commonly seen compared to the other group. It is generally located in one or more places. It may occur as a secondary disorder of various systemic diseases (stress, over-functioning of the thyroid glands, suprarenal gland disorders, menopause, hypoglycemia, obesity, symptoms caused by drugs and hormones used in the treatment of some types of cancers). Its treatment should be intended for healing the underlying disease. Excessive sweating can sometimes be seen as a natural characteristic in people.

What are the Most Common Areas of Excessive Sweating, and What are Its Types ?

  • Hand (palmar) It is one of the places, where excessive sweating is seen the most. Compared to other parts of our bodies, hands have an important place in our social and professional lives. Therefore, people with excessive sweating become shy individuals who limit themselves in their social and professional lives. They hesitate to shake hands. They may move away from social relations. Many of them may have sweaty and also cold palms.
  • Armpit (axillary)
    It is a condition that sometimes shows itself to such an extent that it leaves a mark on the clothes.
  • Foot (plantar)

    Although foot sweating is commonly seen, patients with it can live without problem since it remains out of sight.
  • Face (facial)
    It is in the form of intense sweating that starts from the forehead and covers the whole face. The patient is perceived by others as a nervous and shy person.
  • General Some people may complain of more than one of the above mentioned types of sweating. Sweating may occur suddenly, and has a persistent character. It is usually more noticeable in warm seasons compared to cold seasons.

In What Conditions does Excessive Sweating Appear?

Sweating is known to increase in certain conditions such as pregnancy and menopause, and in case of consuming alcohol, coffee, tea, and spicy foods. Besides these, sweating also increases in some other cases such as Parkinson’s disease, diabetes, hyperthyroidism, heart attack, some cancers, some endocrine gland diseases, and coma. Hyperhidrosis seen in the mentioned diseases may be the concomitant, result or symptom of the exact disease.

How is Excessive Sweating Treated?

Local Treatment

It is one of the most commonly used methods. First, the creams to be used every night before bedtime are recommended. This treatment procedure carried out on a daily basis is utilized in palmar, plantar, and axillary hyperhidrosis, which are not too much discomfortable. This treatment is qualified as the simplest method. But if the sweating is greater, this may not be adequate, and in such a case other treatments can be put into practice.

Iontophoresis Treatment

In the iontophoresis treatment performed by physical therapists in 20-to 30-minute sessions, the sweating area is placed into a container that contains a metal plate, and then a low-voltage current is applied. Sweating is stopped for a certain period of time due to blocked sweat ducts affected by the current. Although the patient feels mild needle pricks during the application, this treatment poses no danger. However, this method needs to be applied to the patient continuously, as well.

Surgical Treatment

Clipping ETS method: This treatment that is also known as the clips procedure dates back to 85 years ago. With the development of endoscopic procedures, carried out by inserting a camera to the cavities of the body through small incisions, surgery began to be commonly used in the treatment of excessive sweating, as well. With surgical treatment, nerves causing excessive sweating in the excessive sweating area are cut. These nerves can also be squeezed with clips, as an alternative to surgery.

Sympathectomy The main mechanism is the blockage of the sympathetic nerve that carries signal to the sweat glands. This procedure can be simply applied to all parts of the body. However, it is an advantage that it can be performed without the requirement of big surgical operations in plantar, facial and axillary hyperhidrosis. Today, the procedure known as ‘Endoscopic Thoracic Sympathectomy’ is applied in moderate and severe plantar, facial and axillary hyperhidrosis. This is a minimally invasive technique. Its success rate is close to 100%.

Curettage is today’s most commonly used method. In this procedure that can be carried out under local anesthesia, only the glands that cause excessive sweating are removed by accessing them through a small axillary incision, and the skin remains intact. This method has been used for about 5 to 6 years. The procedure can be carried out in a hospital. It application time is about 20 to 40 minutes. No noticeable scar remains after the surgery, and the patient can return to normal life within 3 to 5 days. Once it is performed, excessive sweating ends and the patient begins to sweat like a normal person. It is a one-day surgical procedure that does not require hospital stay. Since the skin is not removed in this procedure, the patient recover without any problem and the problems of hyperhidrosis and armpit odor are solved permanently. The result is definitive. And the recurrence of the problem is improbable

Is Botox a Treatment Procedure As Well?

Yes, Botox effectively blocks nerve messages. It temporarily inhibits the functions of sweat glands, by locally stopping the cholinergic nerve impulses, which enable the axillary sweat glands to function. The sweating area in the armpit is identified with iodine-starch test. In the vast majority of our patients, we do not even perform this test. Subcutaneous injections are applied to 10-15 points in the determined area, with very fine injection needles. The procedure is extremely painless, and takes about 10 minutes. After the procedure, the person completely resumes his/her normal professional and social lives.

How Long does the Effect of Botox Last?

Botox is a preparation that shows its effectiveness completely within 7 days. However, a vast majority of the patients, to whom we have applied Botox for axillary sweating problem, report that the effect begin within a shorter period of time, in an interesting way. Although the effectiveness of Botox is classically known to last 4 to 6 months, this effect is observed to last up to 1 year in patients with axillary sweating problem. Despite being rare, we also observe that this period lasts longer than 1 year after a few sessions. In addition the procedure has almost no disadvantage. It is an extremely advantageous treatment procedure that allows for getting rid of sweating problem for a period of 12 months with an operation that takes about 10 minutes.

Is It Possible to Treat Palmar and Plantar Hyperhidrosis with Botox?

Besides axillary hyperhidrosis, also palmar and plantar hyperhidrosis can be treated with Botox injections. Although the success rate of the treatment is a little bit lower compared to the treatment of axillary hyperhidrosis, the results are extremely satisfactory in a vast majority of patients. Since the hand and foot areas are more sensitive to pain, as different from the axillary region, the pain sensation should be minimized by applying anesthetic creams or blocking the nerves before operation.