Most of us experience sweating in the palms, feet and armpits. Producing sweat is almost a part of our daily lives. We treat this phenomenon as normal, sometimes unaware of the times that we produce excessive amounts of sweat. This is the primary symptom of hyperhidrosis. It is usually characterized by producing perspiration greater than the amount the body needed for thermal regulation. At first, we tend to disregard it, until we start feeling sticky in the armpits and our palms stay wet even while at rest. Soon, this uncomfortable condition begins to intrude into and affect your social life. It is probably the right time you knew more about excessive sweating or hyperhidrosis.

According to some studies, 3% of the total population suffers from hyperhidrosis. Most sufferers notice excessive sweating on specific parts of the body such as the underarms (axillary hyperhidrosis), face (facial hyperhidrosis) and feet (planar hyperhidrosis). As you see, sweating on these parts of the body is very common to most of us. We tend to be blind and treat this as normal, not knowing that it is already a symptom of hyperhidrosis. It is not widely known that such a disorder is a very serious medical condition that requires proper diagnosis and treatment.

Hyperhidrosis occurs when there is an abnormal response from the sweat nerves. A part of the brain called hypothalamus is responsible in sending the sensory signals to the sweat nerves. The hypothalamus is located in the chest cavity. The sweat nerves, as a part of the sympathetic nervous system, in turn throws signals to the sweat glands which results to producing sweat. When the signals violate the sending and response process, hyperhidrosis occurs. The sweat glands begin to produce excessive amount of sweats, and this liquid will seek outlets on your underarms, face, palms and feet, resulting to unwanted perspiration in such parts of our body.

We cannot purely blame all this to the uneven responses of our sweat nerves, however. There are a lot of factors contributing to why we perspire so much. By doing intense jobs and heavy activities such as vigorous exercise, we can expel extra liquid in our body. Our emotions can also trigger to generate sweat. Sweating stabilizes the corporal body temperature, especially when doing such activities.

Our skin glands are also the primary factor why hyperhidrosis occurs. Our skin has two kinds of glands: the apocrines and the eccrines. The apocrines do not contribute much in the regultation of body temperature. Basically, these glands can be found in the hair follicle and are not involved in the process of hyperhidrosis. The gland eccrines, on the other hand, is the major contributor for the hyperhidrosis. The increased secretion of the gland eccrines is the cause of such abnormalities. Eccrines are more concentrated in parts of the body such as the armpits, feet, palms, and are very important in regulating the body temperature.

Hyperhidrosis can be primary or secondary. Primary Hyperhidrosis has no specific origin. This is the most common type of hyperhidrosis and is attributed to a genetic factor. Everybody has the tendency to acquire primary hyperhidrosis, and this commonly manifests during the earlier stages of the person’s life. Secondary hyperhidrosis, on the other hand, is an acquired disorder due to an associated cause such as obesity, menopause and the use of antidepressive drugs.

Other factors such excess taking of drugs can cause sweating. Intakes of aspirin and acetaminophen, morphine, excess of the thyroid hormones, lack of feminine hormones during menopausal stage, testosterone deficit for men, and low rate of sugar in the blood can incite hyperhidrosis.

Sweaty Palms are also known by their medical term, Palmar Hyperhidrosis . Profuse hand perspiration is by far the most common kind of hyperhidrosis. The term hypersympathetic activity is a more exact term for sweaty palms. This is because extreme perspiration is caused by the heightened activity in the sympathetic chain. The sympathetic chain is a part of the autonomic nervous system. This is situated inside the chest cavity and it doesn’t have anything to do with the motoric or sensory functions of our body.

Extreme hand perspiration can be very harsh and aggravating to the person with the disorder. This normally affects a person’s daily life and affects both fundamental functions and social interactions. In about forty percent of people that are afflicted with severe hand sweating, the problem can be mostly accredited to genetics. Sweaty palms normally develop during early childhood and may become more severe towards the late adolescence and into early adulthood.

The International Hyperhidrosis Society segregates the severity of Palmar Hyperhidrosis or Profuse Hand Perspiration into 4 subgroups. Group number 1 consists of patients that only have mild hand sweating or perspiration.  This group consists of patients that do not experience any functional or social troubles due to their condition. On the other hand are the patients that experience extreme and excessive hand perspiration. This level of moisture experienced by sufferers is described as dripping or drenching and this adversely affects them on a daily basis. Patients portrayed in the latter group rarely have encouraging results from conservative procedures such as Drionic, Drysol, Maxim, Oral Medications or Botox.

The medical surgery called Thoracic Sympathectomy has been developed and improved over the last five to six decades. In the previous decades, the procedure was made either through the lower neck, at the back or on the chest cavity. These methods involved major surgical intervention that required very long hospital recovery. On top of that, the operation also caused pain and excessive scarring to the patient. These are the reasons why the operation was not commonly chosen by physicians – and not very popular with patients, either.

Over the last two decades, improvements have been made and many successful surgeries were done with the aid of miniaturized cameras. This procedure using the aid of miniature cameras is known as Endoscopic Surgery. Access into the body cavities such as the abdomen or chest is done through miniature incisions wherein a probe that contains a camera can be put into. This is a less invasive procedure and it ends up with minimal surgical damage and a speedier recovery for the patient. Most of the surgeries today are done on an outpatient basis – the patient can go back home on the same day that the procedure is done.  The procedure achieves the same if not better results as the open surgeries that were done in the previous decades. Plus, it has the benefit of a short hospital stay and it does not have the side effects of severe pain and excessive scarring.

Medical treatment for hyperhidrosis typically involves careful assessment by a qualified dermatologist. At first the dermatologist may prescribe lotions or powders to try and mitigate the profuse sweating of the palms and/or underarms.

The surgical procedure to treat hyperhidrosis is called “video-assisted thoracic sympathectomy.” General anesthesia is give to patients who undergo this particular procedure. The surgeon would make 2 very minute incisions under the underarms. The incisions made are about 1 cm. (0.4 in) in length. A small quantity of carbon dioxide (referred to as “air”) is pumped into the chest cavity to shift the lung away from the operative area. The surgeon then inserts a fiber-optic camera and instrument into the incisions. The cameras are used to find the sympathetic chain that is primarily responsible for signaling the sweat glands in our body’s upper limbs and face.

It is the 2nd ganglion in the chain that directs perspiration in the palms and face, including facial blushing. The third and fourth ganglions run underarm perspiration. Your surgeon will normally talk about the different surgical choices for you based on the kind of sweating disorder that you are having.

Surgeons use various techniques in surgery to trace, fasten and get rid of the sympathetic ganglion. The procedure is termed sympathectomy. Upon the completion of the procedure, the surgeon takes out the air and seals the opening or incision. The surgery only leaves 2 minute and inconspicuous scars that are hidden in both underarms.

Success Rate and Results

Video-assisted thoracic sympathectomy’s success level ranges from about ninety-eight to a hundred percent. Surgery on Hyperhidrosis of the hands only has a recurrence rate of seven percent. It has been observed that the success rate is also encouraging for hyperhidrosis involving the axilla, however this particular procedure has a high rate of return.

Investigations have shown that around ninety-four percent of patients who undergo this surgery are satisfied with the results and would be willing to go under the knife again if the need arises. Patients normally experience compensatory sweating after surgery. This only implies that the other parts of the body, like the trunk or thighs, may exhibit more perspiration than is commonly excreted. The majority of patients think that compensatory sweating is more acceptable than hyperhidrosis.

The side effect of compensatory sweating is observed to happen more frequently when the surgical procedure corrects profuse underarm sweating. Surgeries done to correct excessive sweating on the palms, or face, and facial blushing tend to have lesser compensatory side effects. Compensatory sweating gradually decrease within the 1st 6 to 12 months. Heavy compensatory sweating happens in more or less seven percent of all patients. Risks for this surgical procedure are minimal. It is wise to discuss everything in detail with your surgeon before having the procedure done.

When complications occur, they are more often than not of minor significance and would only need an extra day or two of hospital stay to deal with. These complications may consist of:

· Pneumothorax: a tiny quantity of air may linger in the lungs after the procedure or there could be slight leakage from the lung. This usually reabsorbs on its own and treatment is not needed. It is very rare for a patient to require suction drainage to remove the air.

· Horner’s Syndrome: a somewhat smaller pupil and droopy eyelid are caused by injury to the upper ganglion (called the ganglion stellatum). This however is exceptionally uncommon. Blepharoplasty, a plastic surgery procedure to shorten the upper eyelid is call for to correct a droopy eye.

· Bleeding: excessive bleeding is an unusual occurrence. It is however effortlessly controlled by the surgeon. Please discuss the risks involved in the operation in detail with your surgeon.