Hyperhidrosis is the excessive production of sweat (more common in hot countries, such as Cyprus). The sweat production can be up to five times higher than then normal and excessive sweating causes are still unknown. It can affect the entire body, but the most common areas are the armpits, the palms and the feet. It is associated with a significant quality of life burden from a psychological, emotional, and social perspective.
Most common treatments are:
Topical treatment: Aluminium salts is the most effective topical formulation but it works only in mild cases and the duration is usually limited to 48 hours.
Oral (by mouth) Anticholinergic drugs can reduce the activity of nerves surrounding the sweat glands. Unfortunately they can affect the entire nervous system and can cause dry mouth, drowsiness, constipation, tachycardia and even confusion.
Surgery: Surgical treatment can be a permanent solution, but it can have serious side effects and it’s not always effective. It is usually recommended for cases who have not had success using other non-invasive treatments.
For the underarm sweating, sweat glands can be removed by skin excision, liposuction and scratching. Frequent problems are remaining scars and reappearance of the problem. Sympathectomy can be used for the hand sweating. Here the responsible nerves that control the glands can be blocked, either temporarily or cut permanently. Complications include, reactive hyperhidrosis (excessive sweating in another area), nerve pain and gustatory sweating (face sweating induced by food or drink).
Botoulinum Toxin (BoToX): This is usually an effective treatment without major side effects and with long term results. It is considered by many experts as the first choice of treatment. Botox temporarily paralyzes the nerves that stimulates the glands, thus reducing the sweat production.
Initially a solution containing iodine and starch is applied. The solution reacts with the sweat, producing a purple black color. The surface that needs to be injected can be then identified. The amount of the injections depends on the size of the area. Small tiny needles are been used to reduce pain. For most patients treatment will last for six to nine months. After that, treatment has to be repeated.
