What is Hyperhidrosis?

Physiological Definition of Hyperhidrosis - Excessive sweating beyond the bodies normal needs. (Also spelled as hyperhydrosis.)

Hyperhidrosis is a clinical description to a situation in which the body is sweating excessively and beyond the need of a physiological thermal regulation. HH can affect the palms of the hands, (Palmar hyperhidrosis) feet (plantar HH) face (facial HH) and armpits (axillary hyperhidrosis). Hyperhidrosis can also appear in the groin and other localized areas.

Hyperhidrosis is a result of an overactive sympathetic system. The sympathetic system is part of the autonomous nervous system of the body. Hence the name hyper sympathetic activity can be used as well. When this over activity affects the hands it affects only the palms of the hands and not the entire limb. It is the opinion of most doctors that hyperhidrosis is a physiological problem and not a psychological problem.

Physiologically speaking there is a release of a chemical material (acetyl choline). This chemical material causes the release of sweat. This particular fact is the basis for the medical-conservative treatment of hyperhidrosis which is based on medications that acts against the chemical material (acetyl choline).

Hyperhidrosis and Genetics:
Recent genetic studies showed a location on one of the genes that is responsible for palmar hyperhidrosis. We know from studies that genetic connection can be obtained in about 50% of the patients or more. Isolation of that particular location on the genes so far does not lead to any practical solution of the problems. Once genetic manipulation can be applied easily to any disease hopefully it will enable physicians to treat excessive hand sweating with gene manipulation.

Treatment can be a medical or a surgical one. So far medical treatments are very limited with their success, where as the surgical treatment offers long term relief but patients should be aware of possible side effects.

Hyperhidrosis Treatment
In regards to hyperhidrosis treatment currently sympathectomy is being done endoscopically meaning an outpatient procedure with mild to moderate discomfort. The sympathetic nerve can be divided or clipped, depending on the surgeon. Palmar Hyperhidrosis is being eliminated immediately with this procedure. The main side effect is compensatory sweating (reflex sweating) which means that patients will develop sweating on other parts of their bodies. The majority of the patients will tolerate it well, but about 5 - 7% of the patients will develop severe compensatory sweating which can sometimes be more disabling than the initial problem. For further information on hyperhydrosis see expert surgeon Dr. Reisfelds hyperhydrosis page. The site includes excessive sweating information of all types.

Since the success rate for improving the level of plantar sweating (excessive foot sweating) is not that high it now can be corrected surgically with lumbar sympathectomy. In this procedure the sympathetic chain the lumbar-flank region is being approached and the sympathetic chain at the lumbar level L3-L4 is being clamped. This procedure is somewhat more challenging than the thoracic sympathectomy since the location of the sympathetic chain demands more technical expertise. Unlike the thoracic sympathectomy that can be done on an outpatient basis the lumbar sympathectomy is being done with the patient having an overnight stay at the hospital. Since the lumbar sympathectomy is a more demanding operation sometimes a longer hospital stay is needed. So far the vast majority of lumbar sympathectomies have been done with only a one night stay needed. It should be taken into consideration that at times longer stays may be needed.

Source - hyperhidrosis.com

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