Overview of hyperhidrosis symptoms and treatment (misspelled
hyperhydrosis) options. Sweating is necessary
to control body temperature during times of exercise and in warm/hot
surroundings. Sweating is regulated by the sympathetic nervous
system. In 0.6 to 1.0% of the population, this system is revved-up
and works at a very high level causing sweating to occur at inappropriate
times in specific areas of the body. This condition is known
Classification Causes of hyperhidrosis
can be primary or secondary
Regions of the body affected Scalp,
facial (face), neck, palmar (hands), axillary (armpits), truncal (trunk),
Primary or idiopathic hyperhidrosis Hyperhidrosis without a known cause. A more frequent condition
than secondary hyperhidrosis. Localized commonly in the hands,
armpits, scalp, face, neck and/or feet. Starts during childhood or
early adolesence, worsens during puberty, and then persists for
the rest of one's life. Nervousness and psychiatric disorders
are rarely the cause. The excessive sweating is very impairing to almost everything one does during the day. It is embarrassing and makes it hard to focus on the "task at hand" Social, professional, and intimate relationships are often
Secondary hyperhidrosis Caused
by an underlying condition. Usually causes excess sweating of the
entire body, however. Some of these conditions are; endocrine
disorders such as hyperthyroidism, diabetes, endocrine treatment for malignant
disease, menopause, obesity, psychiatric disorders, systemic malignant
disease, to list a few.
Scalp or Head/Face/Neck Hyperhidrosis
and Blushing Excessive
sweating of the scalp, face, neck. Commonly associated with moderate
to severe blushing and burning of the face as well. This condition often causes
the individual to become self-conscious and to develop a low
self esteem. The person tries to cope by avoiding these difficult situations and circumstances.
Palmar or Hand Sweating Hyperhidrosis
Far and above the area of the body causing the most distressing
condition. The hands are used socially and professionally more
than any other part of the body. Excessively wet hands may
even limit the choice of one's profession. Avoiding social
contact is common for individuals with severe Hyperhidrosis Palmaris. Patients notice not only that their hands feel very
wet, but also feel cold too. Some individuals have
a bluish-purple discoloration of their hands and fingers as well.
Axillary or Armpit Hyperhidrosis
Minimally Invasive! An option for underarm sweating treatment called Micro ETS Learn
More Sweating of the armpits causes large wet marks
and staining on the clothes. A strong body odor develops quickly which
can cause very negative emotional/psychological repercussions. Slightly
more common in females than males. The highest incidence occurs
with people of Asian and Jewish ancestry, but can affect all races.
Peeling skin, or sweat blisters, are an example of how excessively
sweaty hands can affect the skin and a person's confidence.
Truncal/Thigh or Torso/Leg Hyperhidrosis
Less frequent. May be associated with sweating of other areas of
Plantar or Foot Hyperhidrosis
Excessive sweating of the feet. Can be associated with hyperhidrosis
of other areas of the body.
Symptoms (Characteristics) Either
sudden onset or continuous sweating. Sweating
usually brought on by no apparent reason. Usually not aggravated
by exercise. Emotional stress, high ambient temperatures, and/or
gustatory stimuli are the most important aggravating factors. Hyperhidrosis
usually improves during the cold/cool months and worsens during
hot/warm months. Sweating usually stops during sleep. Hereditary
(25% of individuals with hyperhidrosis tend to have a family member
with symptoms as well).
as endoscopic thoracic sympathectomy (ETS),
is the treatment of choice for severe hyperhidrosis. Interruption
of nerve impulses to sweat glands of the palms, face, neck, axillae
(armpits) by cutting or electrocautery is called "Thoracic
Sympathectomy". The ganglia (nerve junctions) which lead
to the sweat glands of the palms, axillae, scalp, face, neck are
accessible through the chest (thoracic cavity) because they
travel along the side of the spine of the back right behind the lungs. Dr David Nielson developed Micro ETS, a much less invasvie and more precise procedure. Dr David Nielson performs Micro ETS through a single 1/12th inch axillary incision per side, without collapse of the lungs nor digging (dissecting) the sympathetic nerve out from the inner chest wall tissue to find the nerve, but rather, using the tips of the micro endoshears which are 2 mm (1/12th inch) in diameter, the sympathetic nerve is precisely divided where it crosses the 2nd rib head without injury to the sympathetic nervous system above so that Horner's Syndrome (drooping of the upper eyelid) doesn't occur. Tissue is hardly disturbed so recovery is fast and risk is minimal.
Many surgeons perform ETS through two to three incisions per side, and each incision is much larger, collapse the lungs and disset out the nerve from the inner chest wall tissue which can cause bleeding, more pain, Horner's Syndrome, etc.
In the past, a rib was removed or a large painful
incision was required between two ribs to provide access to this
area. Some surgeons today make three to four small incisions
when performing endoscopic thoracic sympathectomy. Dr.
Nielson has applied state-of-the-art technology to his much less invasive endoscopic technique and he only makes a single 1/12th inch
incision per side.
Precise cut of sympathetic nerve using the tips of the micro endo scissors is
much less painful
Nerve & ganglia are not removed
Surrounding tissue is not disturbed in order to find the nerve, so Horner's Syndrome (drooping of the upper lid) doesn't occur.
Sweating of the face/scalp/neck and Blushing/burning of the face can be improved by stopping all nerve signal precisely at the 2nd rib level.
Sweating of the hands completely ceases and the fingers become warm immediately after the nerve signal transmission is stopped at the 2nd rib level.
T2 level cut only (T2/T3/T4 for severe axillary
Kuntz nerve cut
Out-patient surgery (discharged a few hours after)
No sutures required
Operating time is short, postoperative pain and discomfort are minimal for patients who undergo this micro-incision
technique "Micro ETS". Improvement is seen immediately for Hyperhidrosis of the scalp, face, neck, hands, axillae and Blushing/burning of the face/neck. Hands/fingers become warm as well. Patients
leave the operating room with a dry scalp, face, neck, hands, and axillae. Excessive
sweating of the whole body and/or trunk cannot be treated surgically.