Hyperhidrosis or excessive sweating is a frequent problem. About 2-3% of the population carries some degree of alteration of sweating, being in its most severe forms a condition that causes a great impact on our quality of life and social performance.
Localized hyperhidrosis, also called primary or idiomatic, differs from other states in which sweating is an expression of infectious, hormonal, oncological, and other diseases. The latter form is called generalized hyperhidrosis and requires a thorough study.
Primary hyperhidrosis begins at early ages, during puberty or adolescence and affects certain areas of our body such as the palms of the hands, armpits, soles of the feet or face. It is characterized by being a symmetrical condition, Ie it affects both sides equally and increases in episodes of daily life or work, in which we are subjected to stress. He generally respects sleep.
There are ways to certify and quantify the magnitude of hyperhidrosis, two important factors when choosing the best treatment. During the last decade, effective treatments for this condition have been developed, ranging from topical dermatological treatment in mild forms, to video endoscopic sympathectomy in more severe cases, achieving permanent and satisfactory results in more than 95% of cases.
The Following Table Shows The Criteria Used For The Diagnosis:
Diagnostic criteria for localized idiopathic hyperhidrosis
The presence of Excessive Sweating Hyperhidrosis located in armpits, palms, plants and / or face, visible and of at least 6 months of duration, without apparent cause and that meets at least 2 of the following characteristics:
a.Sudoración bilateral and relatively symmetrical
B.At least one episode of hyperspiration a week
c.Difficulty in daily activities due to sweating
- Age of onset of sweating in children under 25 years
e.History of hyperhidrosis family
f.Excessive sweating during sleep
The Following Table Shows A Survey Used To Grade The Severity Of Hyperhidrosis.
A primary hyperhidrosis presenting two or more of the following criteria is considered severe:
Hyperhidrosis severity survey
A.Sensation of severe embarrassment associated with clothes or wet or wet palms
b.Need of change of clothes 2 or more times per day
c.Evitar greet with hand
d.Frustration in daily activities
e.Decreation of work performance or productivity
- Avoid social encounters with friends or family
g.Change in the type of recreational activities
h.Depression and low self-esteem
i.Bacterial infections and fungi produced by macerated skin
j.Difficulty in establishing social and intimate relationships.
The Treatment Of Hyperhidrosis Should Take Into Account:
– The primary and non-secondary character
– The location (armpits, palms, plants and associations)
– Failure of other therapeutic attempts
The treatments can be classified in:
It consists of the direct application on the skin of creams with aluminum salts to 20-25%.
Iontophoresis consists of exposing the skin and its glands to low current loads.
There are families of drugs that modify the action of the autonomic nervous system such as beta-blockers, anticholinergics and some drugs with effects on the central nervous system.
Botulinum Toxin Botulinum
toxin type A or Botox® is a substance that blocks the stimulation of the sympathetic system on the sweat gland.
Video Endoscopic Sympatectomy
Basically consists of the resection of a small portion of the nerve chain, Using a camera and a special instrument of 3 to 5 mm of diameter, that are introduced by two incisions of 3 to 5 mm made in the anterior fold of the axilla. It is performed under general anesthesia, and usually requires less than 24 hours of hospitalization.