Hyperhidrosis is the excessive sweating that occurs in some people. There are different techniques to treat it. According to experts in Thoracic Surgery, since there is no definite cause, the treatment is symptomatic, since the aim is to eliminate the excessive sweating. Certain hygienic measures such as absorbent powders, wearing cotton clothes, leather shoes or avoiding rubber, help to reduce sweating.
Topical agents
The use of topical agents on the affected area is usually used as initial treatment and is effective in 25%-60% of cases. The most common are 2% aluminum hexachloride solution, which blocks the sweat ducts. It is preferred to be used at night and another drug (an anticholinergic) can be used to prevent sweating once the aluminum chloride solution is removed.
Iontophoresis
If the patient does not respond to topical treatment, one option is iontophoresis. This technique consists of introducing ionic salts in water. The affected area is placed in the water for 10 to 20 minutes daily for one week. It is then repeated once a week or month. Although the treatments can be effective, its practice is time consuming and creates a great dependence on the patient, which makes some patients get tired of this routine.
Botulinum toxin type A
Botulinum toxin type A is a neurotoxin that is administered intradermally by direct injection in the areas of the armpit, palms of the hand or forehead. One per cm2 is administered. It inhibits sweating for approximately 5 months, depending on the dose. This treatment is most effective when applied in the armpit area.
It has some complications which may include local muscle weakness and headaches. Injections are effective but painful and expensive.
Psychotherapy Techniques
Psychotherapy techniques are of limited effect and prolonged in time, requiring excessive dedication and perseverance with, so far, uncertain results.
Surgical treatment
Surgical treatment in cases of hyperhidrosis is indicated for patients who have previously undergone other unsuccessful treatments.
Patients with axillary sweating can be treated with surgical resection of the sweat glands in that area by open dissection or liposuction.
Patients with palmar, axillary, cranial sweating and facial flushing can be treated with bilateral videothoracoscopic sympathectomy. It is a very painless operation and often after 48 hours the patient no longer needs painkillers. Recovery is very fast and the person can return to work in 48-72 hours. The results are very satisfactory, generally more than 92%, especially in the palmar, somewhat less in the axillary and more doubtful in the blush.
The quality of life index registers very high levels with a considerable decrease in the level of anxiety.
Videothoracoscopy is the reference treatment in primary hyperhidrosis due to the results, quality of life and degree of satisfaction.