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Hyperhidrosis - Beautopedia


This guide provides information about the types of hyperhidrosis, ways of eliminating excessive sweating and the side effects and costs involved.

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What is Hyperhidrosis?

Hyperhidrosis is where the body sweats in an excessive and unpredictable manner. Under normal circumstances, people typically sweat when the temperature is warm or hot (the body’s way of cooling) or when they experience nervousness, fear, embarrassment or anger. Hyperhidrosis sweating occurs when the body sweats without any of these triggers. The body’s overactive sweat glands can cause such perspiration for any number of reasons.

What are the Types of Hyperhidrosis?

Excessive sweating can occur in a variety of ways. The first distinction is where the perspiring occurs for no apparent reason or medical condition. This is known as primary hyperhidrosis and affects approximately 2-3% of persons. Also known as focal hyperhidrosis, the condition seems to be hereditary. On the other hand, secondary hyperhidrosis is where extreme sweating occurs as a result of another medical condition such as anxiety, cancer, heart disease, spinal cord injury or a stroke.

Whether the perspiration is primary or secondary, the region which is affected can be the whole body or any part of it. Common areas which have overactive sweat glands include the hands, feet, armpit, face and the back.

Gustatory hyperhidrosis is a type which strikes the forehead, perioral region, the upper lip or sternum after a person eats certain foods such as coffee or spicy meals. Generalized hyperhidrosis is where the sweating appears due to vigorous exercise or a hot humid environment. Cases of undue sweating which are localized also have specific names. For example, axillary hyperhidrosis refers to excessive sweating in the armpit whereas palmorplantar hyperhidrosis affects the feet and hands.

Treatments for Armpit Hyperhidrosis

Sweating in the armpit is normal for most adults. However, where the secretion is excessive this can lead to both physical and emotional concerns for the patient. Firstly the doctor will test whether there is actually too much wetness. Common tests include the starch-iodine test or the paper test. After axillary hyperhidrosis is confirmed, there are various options for treatment.

Hyperhidrosis Antiperspirants

One method of reducing the effects of sweat is by using aluminium chloride deodorants. These products are applied topically and essentially block the sweat ducts. Products which contain a higher concentration of aluminium chloride can be prescribed for night use. Whilst the antiperspirants do not stop the sweating problem, they do reduce associated body odor. This provides temporary relief for the patient in situations where they are exposed to other persons such as during work or social outings.

As a side effect, these deodorants can cause skin irritations and can also damage clothes. Whilst it’s an ongoing treatment, the use of the deodorants can be reduced over time. For example, a prescribed use may be 3-7 times per week, reducing to 1-3 times a week once the sweating is under control. If there is skin irritation, the doctor may prescribe a steroid based cream. However, this can only be on a temporary basis.

Hyperhidrosis Injections

Another method of treating hyperhidrosis in the armpit is through the use of Botulinum toxin type A injections such as Botox or Dysport. The doctor injects the substance into the armpit, disabling the patient’s sweat glands. Depending on the site of injection, the sweating may continue for four to nine months following treatment. Once the perspiration subsides, a single injection can be effective for several months. Some patients may require more than one injection.

This procedure is painful and patients often experience swelling following the injections, which usually subsides within a few weeks. Patients can also experience flu-like symptoms, temporary weakness as well as intense pain with botulinum toxin injections. Once again, this measure is only short-term and the sweating will resume unless treatment is continued by the patient.

Axillary sweating can also be treated using sweat gland removal or destruction techniques. This involves suctioning out or destroying the sweat glands using various methods such as liposuction or laser sweat ablation. The procedure can remove up to 30% of the sweat glands, eliminating a proportionate amount of the sweat.

Treatments for Hyperhidrosis of the Palms & Feet

Also referred to as palmoplantar hyperhidrosis, patients can experience localized sweating on both of their hands and feet or just one of these areas. One method of treating excessive sweating which affects the hands and feet is through the use of medication. Antitolinergic drugs such as Robinul, Robinul-Forte and Ditropan help to prevent the stimulation of sweat glands. This can be an effective treatment option for some patients. Side effects include dry mouth, problems with urination and dizziness.

Where the patient does not wish to use prescription medication for hyperhidrosis, another option includes the use of electric currents with iontophoresis. This treatment involves immersing the patient’s hands or feet in water and slowly increasing the electric current which passes through the body up to where the patient feels slight tingling. Patients typically require about 6 to 10 treatments before seeing results, with each session taking about 10 to 20 minutes.

This procedure is FDA approved and is used to provide relief on a temporary basis by switching off the sweat glands. The rare but possible risks involved with iontophoresis include blisters and skin crackling. After the sweating reduces, patient may need to repeat the treatment weekly or monthly, depending on the severity of the case and the directions of the physician.

Where the patient has tried some or all of the less invasive options, the final recourse which a doctor may suggest is surgery. The procedure, known as endoscopic thoracic sympathectomy (ETS) is minimally invasive, however there are risks which you need to research and consider. One of these is compensatory sweating, where the patient will experience more perspiration in other parts of the body. This is typically seen in 20 to 80% of cases.

Whilst most people are able to manage this side effect, others claim their overall sweating condition has worsened since their total body sweating has increased. In some cases ETS is not successful because the symptoms recur due to nerve regeneration. This often occurs within six months of the procedure. There are other types of sympathectomy procedures such as lumbar and percutaneous sympathetctomy, which are also used for this type of sweating.

Is Hyperhidrosis Embarrassing?

Excessive perspiration can cause embarrassment in many situations, depending on where the disproportionate sweating occurs. For those with sweaty feet, the condition can often be hidden with breathable socks and footwear. However, where the condition is severe, the soles of the feet can grow a bacterial fungus and become infected, causing bad odor and also pain for the patient.

As for armpit sweating, this can be very disconcerting where pungent odors are involved and/or sweat stains are visible on the patient’s clothing. This can be especially humiliating in the work situation, particularly in an office or corporate setting. With sweating on the hands, patients often avoid handshakes due to being ashamed of their overly wet hands.

Fortunately, there are various options to help reduce perspiration whether localized or full body for these patients. The success rate of a particular treatment will depend on each individual patient and should be discussed with your doctor. Having hyperhidrosis can be a very distressing and uncomfortable condition. If you are experiencing undue sweating, contact a cosmetic surgeon or speak to your doctor about available treatment options.

How much does Hyperhidrosis Treatment Cost? Price Information

Price Range: $$ affordable $$$ moderate $$$$ high-priced

Price Indicator: $$$

Cost of Hyperhidrosis Injections: $10 to $13 per unit with 80 to 150 units being required per armpit treatment (being approximately $800 to $1950 for both armpits).

Cost of Endoscopic Thoracic Sympathectomy (ETS): $8,000 to $13,000

These Prices are Per Treatment and Usually Include:  injections, surgeon fees, facility/hospital fees

Additional costs of Hyperhidrosis may include:

- prescription medication

- anesthetic

Medicare/Medicaid:may be covered

Private Health Insurance:covered by some health insurance plans, particularly where the condition is a medical problem.

Financing:may be offered by some surgeons or companies.

Factors affecting the Cost of Hyperhidrosis:

-          Where the sweating occurs (armpits, face, hands, feet, palms, back, overall body)

-          Which treatment method you choose

-          The size of the area being treated

-          Location of treatment

When asking for a quote, ask the clinic for the total cost including all fees and whether any rebates, specials or discounts apply.

How to Find the Best Hyperhidrosis Doctor/Specialist

Hyperhidrosis is a medical condition which should be treated by a qualified doctor or cosmetic surgeon specializing in excessive sweating. Some cosmetic surgeons allow their nursing staff to administer botox injections as part of the treatment. If you can, try to have an MD carry out all of the treatment. When searching for a Hyperhidrosis specialist, make sure you research their qualifications, credentials, training and experience. Being board certified by the American Board of Cosmetic Surgery does not indicate that a doctor is trained and experienced in this treatment.

As for ETS (Endoscopic Thoracic Sympathectomy), this is a surgical procedure procedure which requires specialty training and experience. Although any doctor can be a cosmetic surgeon and claim to practice in plastic surgery, invasive surgeries should only be done by a plastic surgeon that is board certified by the American Board of Plastic Surgery. To ensure the surgeon is also experienced in cosmetic surgery, find out if they are a member of the ASAPS (American Society for Aesthetic Plastic Surgery). If the surgeon does not have hospital privileges for the procedure, make sure that the surgeon’s facility is accredited, state licensed or certified by Medicare.

Be sure to ask your doctor which procedures they specialize in, where they trained and how many treatments they’ve performed. Obtain lots of before and after photos of patients they’ve treated for the same area using the treatment you require.

Even if a doctor has the right credentials, this does not mean they will be good at performing Hyperhidrosis. Apart from researching their formal qualifications and training, try to find customer reviews to see the overall satisfaction rate of your potential doctor. Independent recommendations are invaluable for assessing the best doctor or surgeon who is most experienced in the treatment. Don’t be tempted to opt for the cheapest cost without considering the above factors. A cheap center may not offer the experience you desire. Also, you may wish to consider whether you feel more comfortable with a female or male physician.

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