Hyperhidrosis is excessive sweating that occurs in some people. There are different techniques to treat. According to experts in Thoracic Surgery , the absence of a definite cause, treatment is symptomatic, since it aims to eliminate excessive sweating. Some examples hygienic measures such as absorbent powders, wear cotton clothes, leather shoes or rubber prevent, help reduce sweating.
The use of topical agents to the affected area usually used as initial treatment and is effective in 25% -60% of cases. The most common are the aluminum hexachloride solution 2%, which blocks the sweat ducts. It is preferred to use at night and you can use other medication (an anticholinergic) to prevent sweating once the aluminum chloride solution is removed.
If the patient does not respond to topical treatment, an option is iontophoresis. This technique involves introducing ionic salts in water. The affected area is introduced into the water for 10 to 20 minutes daily for a week. After repeated once a week or month. Although treatments can be effective, their practice is time consuming and creates a dependency to the patient, making some patients get tired of this routine.
Botulinum toxin type A
Botulinum toxin type A is a neurotoxin that is administered intradermally by direct injection into the armpit areas, palms of the hand or forehead. one is administered per cm2. Inhibited perspiration for about 5 months, depending on the dose. This treatment is most effective when applied to the underarm area.
It presents some complications that may be local muscle weakness and headaches. Injections are effective even if they are painful and expensive.
Psychotherapy techniques are of limited effect and prolonged in time requiring excessive devotion and perseverance with results so far uncertain.
Surgical treatment in cases of hyperhidrosis is indicated for patients who have previously made another unsuccessful treatment.
Patients with underarm sweating can be treated with surgical removal of the sweat glands in that area by open liposuction or dissection.
Patients with palmar, axillary, cranial and facial flushing can be treated with bilateral sympathectomy by VATS. It is a little painful and frequently at 48 hours operation the patient no longer required analgesics. Recovery is very quick and the person can return to work within 48-72 hours. The results are very satisfactory, generally more than 92%, especially in the palmar, axillary something less and more dubious in the flush.
The quality of life index has very high levels with a considerable drop in the level of anxiety.
VATS is the reference treatment in primary hyperhidrosis DULY or outcomes, quality of life and satisfaction.