• Introduction

    Hyperhidrosis

Excessive sweating or primary hyperhidrosis is a relatively common problem. It is basically the production of sweat in greater quantities than is required for the normal temperature regulation of the body.

Classic areas that are affected by excessive sweating are:

  • Underarms
  • Palms of the hand
  • Soles of the feet

Other areas such as the face, scalp, groin and below the breasts may also be affected.

Although not a significant threat to physical health, it can be a very distressing condition. It can also increase the likelihood of developing other skin conditions such as fungal infections and bacterial skin infections and warts/verrucae. It can affect people socially, professionally and emotionally in many ways including:

  • Visible staining of clothes
  • Moist handshake
  • Difficulty with tasks that require dry grip
  • Discomfort and maceration of skin due to profuse sweating
  • Increase in likelihood of developing other skin conditions

There are many ways in which Doctors can help with excessive sweating. In the first instance prescription strength antiperspirants containing aluminium chloride can be prescribed. These are helpful but function only by physical plugging of the sweat glands.

Sometimes if sweating is profuse and affecting multiple areas, Doctors can prescribe tablets (anticholinergics, benzodiazepines and beta-blockers) but unfortunately these treatments are often responsible for other unpleasant side effects that lead to them being an undesirable option for most patients.

Iontophoresis is a treatment that uses electrical current to inhibit sweating. It is used for the treatment of hands and feet. It is difficult to apply to other areas. Unfortunately this treatment requires multiple time-consuming applications which makes it an impractical solution for busy professionals.

Energy Devices are being developed and are showing promise for the treatment of excessive sweating. An example of this is the Miradry device. However due to the high cost of devices, treatment costs are high and there is still debate over the long term efficacy of treatment. Certain areas such as the palms and soles are difficult to treat due to anaesthetic issues and potential for thermal injury/burns.

For very severe cases of excessive sweating surgical options (Endoscopic Thoracic Sympathectomy ETS procedure) are a last resort. For most patients it is an undesirable route due to the severity of treatment and potential for lifelong complications. However it can be a route chosen when all other routes fail.