Hyperhidrosis Questions and Answers

1. What is hyperhidrosis?
2. What is palmar hyperhidrosis?
3. Why is palmar hyperhidrosis a problem for people?
4. What types of hyperhidrosis can be helped by surgery?
5. What other treatment options are there for managing hyperhidrosis?
6. What is a thoracoscopic sympathecomy?
7. How is it used to treat palmer hyperhidrosis?
8. Do I need to stay overnight in hospital?
9. What is the healing process?
10. What type of follow-up care is needed?

Question 1: What is hyperhidrosis?

Answer:
Hyperhidrosis is generalized or localized excessive sweating of physiologic needs. We sweat as a normal bodily function in order to keep ourselves cool. Patients who experience hyperhidrosis sweat in excess of that needed to properly regulate their body temperature.

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Question 2: What is palmar hyperhidrosis?

Answer:
Palmar hyperhidrosis refers to excessive sweating of the hands.

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Question 3: Why is palmar hyperhidrosis a problem for people?

Answer:
There are two main reasons that palmar hyperhidrosis becomes a problem for people. The first reason is that it causes functional impairment. This means that people who experience palmar hyperhidrosis have difficulties doing routine activities at work, school, and around the home. For example, a person suffering from palmar hyperhidrosis might have trouble producing written work — it often gets smudged due to the excessive sweating of the hands which drips onto the paper. In other cases, an individual may find it difficult to safely hold hand tools or to conduct manual labor. Driving a car or operating machinery can also be a problem.

The second reason is that is excessive hand sweating causes social embarrassment. Excessive sweating of the hands creates a false perception that the patient suffers from a nervous condition, when in fact this is not the case. It creates aversive behavior among friends and acquaintances, during such activities as dating, shaking hands, or, especially for young children, participating in classroom activities.

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Question 4: What types of hyperhidrosis can be helped by surgery?

Answer:
Surgeons can reliably control palmer hyperhidrosis in a permanent fashion by means of a thoracic sympathectomy, an operation during which a chain of nerve ganglia (the sympathetic chain) in the chest is interrupted. Sometimes, excessive perspiration in other areas (feet, armpits) is also helped by this hyperhidrosis surgical procedure.

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Question 5: What other treatment options are there for managing hyperhidrosis?

Answer:
There are several medical hyperhidrosis treatments that are available as options to managing excessive sweating.

• Topical antiperspirants can be applied to hands, armpits and feet. This hyperhidrosis treatment option is non-invasive, but needs to be applied daily (or more frequently) to the affected area. For many people, this treatment is only moderately effective, and often quite inconvenient.
  
  
• Anticholinergic drugs can be prescribed for hyperhidrosis. These drugs tend to dry-up bodily secretions. They have a number of significant side effects, including effects on the cardiovascular system (rapid heart beat), dry mouth, dizziness, somnolence, and blurry vision. They are contraindicated in patients with certain disease conditions, such as glaucoma, urinary retention, myasthenia gravis, kidney disease, and intestinal conditions.
  
  
• Psychotherapy and biofeedback techniques have also been tried in the treatment of hyperhidrosis. These options are largely ineffective because hyperhidrosis is not typically a reflection of a psychiatric illness or a nervous disorder.
  
  
• Iontophoresis is a technique whereby the affected area of the body (i.e., the hands) is immersed in a solution through which a small electrical current is passed. This option needs to be repeated frequently. It is time-consuming and is only moderately effective, if at all.
  
  
• Botox injections into the skin of the affected area are another option for hyperhidrosis. These injections need to be repeated every few months. They are very costly, and when used on the hands, muscular weakness can result.

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Question 6: What is a thoracoscopic sympathecomy?

Answer:
A thoracoscopic sympathectomy is an operation that interrupts certain nerve ganglia in the chest that control autonomic functions, including perspiration.

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Question 7: How is thoracoscopic sympathecomy used to treat palmer hyperhidrosis?

Answer:
Surgeons have found that the interruption of a portion of the sympathetic chain in the chest can effectively control palmer hyperhidrosis. This hyperhidrosis surgery is typically done as a minimally invasive procedure, under general anesthesia, using a small camera and surgical instruments that are inserted into the chest through several small incisions.

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Question 8: Do I need to stay overnight in hospital?

Answer:
Most hyperhidrosis patients typically can go home several hours following their procedure.

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Question 9: What is the healing process?

Answer:
Most hyperhidrosis patients’ are able to return to work within a week. Post-operative pain is easily managed with prescription pain relievers for the first several days after the procedure.

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Question 10: What type of follow-up care is need?

Answer:
There is no need for long-term follow up care. Results are immediate and durable. Your hyperhidrosis surgeon will follow-up with you shortly after your operation to ensure you have successfully recovered from the procedure.

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