Hyperhidrosis is the condition characterized by abnormal, profuse sweating, in excess of that required for regulation of body temperature. For some, the abundant sweating is localized to one area, such as the hands, while others may experience increased sweating in a combination of areas.
It can affect one or a combination of the following:
- Hands, called palmar hyperhidrosis
- Armpits, called axillary hyperhidrosis
- Feet, called plantar hyperhidrosis
Hyperhidrosis is rare, affecting about 1 percent of the population. It affects men and women equally, and most commonly occurs among people aged 25–64 years. Some may have been affected since early childhood. There may be a genetic predisposition to hyperhidrosis, as approximately 30–50% of sufferers have another family member afflicted.
Often there is no identifiable cause, but excessive activity of the sympathetic nervous system is believed to be responsible in the majority of those affected. The sympathetic nervous system controls the sweating throughout the body. These nerves primarily affect blood flow to the skin and the function of the sweat glands.
Symptoms of hyperhidrosis often become noticeable during childhood and adolescence. In many cases sweating can be quite severe, affecting everyday life and causing social embarrassment. It is thought that the excessive sweating may be brought on by stress, emotions or exercise. However, it also can occur spontaneously.
The excessive sweating often interferes with daily activities. For example, patients with palmar hyperhidrosis have wet, moist hands that sometimes interfere with grasping objects. Those with axillary hyperhidrosis sweat profusely from their underarms causing them to stain their clothes shortly after they dress. Plantar hyperhidrosis, excessive sweating of the feet, makes ones socks and shoes wet, which leads to increased foot odor.
Many patients with hyperhidrosis try topical medications or herbal remedies to ease their condition, but these efforts have only temporary or no benefit. The only treatment with proven long-term results involves surgical interruption of the sympathetic chain. Interrupting the sympathetic nerves in the chest results in dilation of the veins and arteries in the arm and hand as well as the complete blockage of sweating.
A minimally invasive procedure called endoscopic thoracic sympathectomy (ETS) can be used to treat hyperhidrosis. Using very small incisions, the sympathetic chain is cut or clamped to eliminate the excessive sympathetic nerve activity. Using this approach, the procedure may be done on an outpatient basis with quicker recovery and less scarring than open surgery. The procedure is highly effective in eliminating excessive sweating of the hands in over 98 percent of patients. In addition, the risk of complication is very low. ETS also can be applied in selected patients with axillary hyperhidrosis, or excessiving sweating of the armpits.