What is hyperhidrosis and what causes it?
Sweating is a physiological mechanism of the body to regulate temperature. When this sweating is greater than it should be we usually speak of hyperhidrosis. We can say that there are two main types of hyperhidrosis: hyperhidrosis secondary to some pathological processes, tumors, infections, etc.; and primary hyperhidrosis, which is the one we are dealing with at the moment. The most important areas of involvement are the palms of the hands, soles of the feet and armpits. This primary hyperhidrosis seems to be mediated by the autonomic nervous system, specifically the sympathetic autonomic nervous system, and due to a hyperexcitation of this system the secretion of excessive sweat in the hands and other parts of the body is produced.
Is surgery a definitive solution?
This primary hyperhidrosis, when it becomes really bothersome for the patient, has several forms of treatment. Conservative treatments, usually directed by dermatologists, such as iontophoresis, can be useful in mild or moderate cases. In more severe cases, botulinum toxin can also be used, which stops palmar hyperhidrosis for a period of four, five or six months, although the problem is that it is temporary and the doses have to be repeated. For severe palmar hyperhidrosis with poor control with conservative means, the technique of bilateral thoracic sympathectomy performed by videothoracoscopy with very small caliber instruments, produces a definitive solution with very little discomfort and risk for the patient. With a success rate of approximately 95% of cases.
What care should I take after the operation?
Once the intervention has been performed, which in some cases can be performed on an outpatient basis, although in practically all cases the patient is already at home within 24 hours. Care is minimal since the skin incisions are small, less than 5 millimeters, pain is very well controlled in the first hours and practically within a week the patient is leading a normal life.