Excessive sweating of the hands, feet, face or underarms is medically termed hyperhidrosis and affects approximately 3 percent of the population. Medically, the condition is harmless; but, for those afflicted with hyperhidrosis the condition causes extreme discomfort and social embarrassment. The condition is treatable with oral medications, Botox injections or surgical procedures.
Primary hyperhidrosis is characterized by excessive sweating that is not related to another medical condition and is not a side effect of medication. It usually occurs beginning in childhood or adolescence and affects a specific part of the body. Sweating is not experienced during sleep. In secondary hyperhidrosis excessive sweating occurs as the result of an underlying medical condition or as a side effect from medications. Sweating frequently occurs during periods of sleep, as well as waking hours.
Treatment options range from the topical application of powders or antiperspirants to surgical measures to curtail excessive sweating. Topical applications are the first line of treatment and may be effective for many individuals. Iontophoresis has proven to be effective for a wide range of people. It uses water to conduct a mild electrical current to the skin of the affected area, generally sweaty palms or feet. The patient, under the supervision of a medical doctor, soaks the feet or hands in the solution for 20 to 40 minutes on a regular schedule of alternating days for up to 10 days, or until sweating has decreased to an acceptable level. Maintenance requires repeated treatments from once a week to once a month
Botox injections have been effective in decreasing excessive sweating by 50 percent in 81 percent of patients. Small amounts of Botox are injected into the local area of excessive sweating. The effects are temporary and may require repeated injections at intervals of 6 to 17 months. When other treatments have been unsuccessful, local surgical procedures can be performed to scrape or remove the offending sweat glands. Results vary but are often successful.
As a last resort, some patients opt for Endoscopic Thoracic Sympathectomy, or ETS. This procedure involves invasive surgery where a small camera is inserted under the arm and used to view the chest cavity. The nerve responsible for regulation of sweating is clamped or cut to intercept the signal for excessive sweating. The procedure requires the deflation on one lung in order to access the nerve. It is reinflated and the procedure is repeated on the opposite side.
The ETS results in a decrease in sweating in the hands, feet, underarms and face, but a major side effect is compensatory sweating of the back, thighs or abdomen in 80 percent to 90 percent of patients. The compensatory sweating is often more bothersome than the original complaints, with 50 percent of those patients experiencing compensatory sweating that requires changing clothes during the day because of excess sweating.