Lifewatch: Excessive sweating

Reported by Claire Hosmann - bio|email
Posted by Debra Worley - email

(WECT) - More than 1 percent of the world's population suffers from excessive sweating.  It can affect a patient in many ways, including their social relationships, personal confidence, and emotional levels.

Chrissey Stull used to sweat so much social situations were difficult.

"Shaking people's hands and just human contact in general was horrible," said Chrissey.  "It was extremely embarrassing."

Chrissey suffered from excessive sweating or hyperhidrosis.  It can affect a person's hands, arm pits, feet, and face.

"The sympathetic nervous system is wired abnormally in these people so that they're more sensitive to the normal triggers for sweating," said neurosurgeon, Dr. Curtis Dickman.

Surgery used to mean cutting open the chest and spending at least a week in the hospital.

"It was a tremendously painful procedure and was very difficult to identify these sympathetic nerves with that very invasive technique," said Dickman.

Now doctors make two small incisions under the arm pit and cut the nerve that supplies the sweat glands.  Patients go home the same day.

In a recent study of 300 patients, the surgery was successful in treating over 99 percent of those with hyperhidrosis of the hands and 61 percent of those with excessive sweating under the arms.

There's a risk the surgery can cause nerve damage.  Dr. Dickman said the most common side effect is increased sweating in other areas of the body.

For more information, please contact:
Carmelle Malkovich
Public Relations
St. Joseph's Hospital and Medical Center
Phoenix, AZ
(602) 406-3319

BACKGROUND: Up to 1 percent of the population suffers from hyperhidrosis, a disorder characterized by excessive sweating. According to the Society of Thoracic Surgeons, this sweating can occur in the hands, armpits or feet. Nobody understands the exact cause of hyperhidrosis, but doctors do know the sympathetic nervous system -- which controls sweating -- plays a role. The sympathetic nervous system is a component of the autonomic nervous system, which is the involuntary part of our nervous system. In addition to sweating, the autonomic nervous system also controls breathing and the heartbeat.

SYMPTOMS: A 2008 survey by the International Hyperhidrosis Society found one-third of U.S. adults are worried that they have too much underarm sweat, yet only 3 percent of the U.S population is diagnosed with hyperhidrosis. The Society of Thoracic Surgeons says symptoms of hyperhidrosis of the hands -- or palmar hyperhidrosis -- is characterized by moist hands that interfere with grasping objects or shaking hands with people. Axillary hyperhidrosis causes a person to sweat profusely from the underarms, enough that their clothes are stained shortly after dressing. Plantar hyperhidrosis causes so much sweating from the feet that socks and shoes are often moist.

TREATMENTS: First-line treatments for hyperhidrosis include special antiperspirants and iontophoresis, a procedure that involves using water to conduct a mild electrical current through the skin. Local injections of Botox have been shown to safely alleviate excessive sweating of the armpits, hands, feet and face.

Surgery is recommended by doctors only for certain severe cases of hyperhidrosis. Traditional surgery involves removing the sympathetic chain, a cluster of nerves in the chest that controls sweating. Recently developed techniques allow surgeons to simply cut across the chain using an endoscope and small tools. Surgeons can access the chest cavity through two small incisions underneath the armpit. To work in the chest area, surgeons are required to collapse one of the lungs.

MANAGING SWEAT: The International Hyperhidrosis Society recommends the following ways to manage excessive sweating:

  • Drink water early and often. Staying hydrated keeps the internal air conditioning system working properly.
  • Wear loose, lightweight clothing to enable evaporation.
  • Wear open sandals when possible, or wear  sweat-absorbing inserts
  • Use antiperspirant twice a day -- once in the morning and once before bed. Some people may consider using a prescription antiperspirant formula.

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