¿Qué puedo hacer si las palmas de las manos y las axilas me sudan demasiado?
Written by:The doctor. Corcoles is a specialist in Thoracic Surgery of Alicante expert in the treatment of pathologies such as hyperhidrosis, disease of which speaks in this article. The doctor develops what is this disease, how it is diagnosed and what are the most effective treatments to combat it.
It is relatively common for certain people to have excessive sweating on the palms of the hands, armpits and / or soles of the feet. Many times it is assumed as a variant of normality and a solution is not sought. It is the so-called primary hyperhidrosis.
What symptoms does a primary hyperhidrosis have?
The usual thing is hyperhidrosis that manifests itself being young, and its symptoms usually have appeared during childhood or adolescence.
Sweating especially affects certain areas, such as the palms of the hands, armpits and / or soles of the feet. It is an excessive sweating, not consistent with what should be logical, since you sweat these areas even in winter or when it is cold, although it is true that in times of heat like summer, during the exercise, or especially when the patient suffers from a nervous state, sweating becomes greater.
In the case of hands or armpits, they come to drip, and the soles of the feet cause a very unpleasant sensation with sandals or flip flops in summer when slips occur.
It is, therefore, a sweating so exaggerated that affects the daily life of the patient, influencing their activities while working, in their personal relationships and causing a deep discomfort and a certain degree of psychological impact due to popular thinking about people who sweat in excess.
Otherwise, you are healthy, you do not have diseases that may have caused such excessive sweating, or take any medication that may cause excessive sweating.
What causes primary hyperhidrosis?
When a patient with these characteristics is evaluated, the first thing that must be ruled out is that these symptoms are being caused by the taking of certain medications or the presence of diseases that may secondarily cause these symptoms.
Once discarded, the suspicion will indicate a possible focal primary hyperhidrosis. It is a disorder of unknown cause, in which there is an excess of activity of the part of the nervous system that regulates sweating (autonomic sympathetic nervous system).
Under normal conditions, sweating has the function of lowering the temperature. Therefore, any person in summer, when it is very hot or during exercise, sweats physiologically. When there is an alteration of the sympathetic nervous system, this disorder appears, which can be very annoying and disabling.
What treatment alternatives exist against hyperhidrosis?
There are many degrees of manifestation of hyperhidrosis, from mild to severe cases. Therefore, it is recommended to consult with a specialist in Thoracic Surgery with experience in this disease.
As a rule, you start with topical treatments such as antiperspirants, or some medications by mouth. In moderate or severe cases, treatment with botulinum toxin may be considered, although it is a non-definitive treatment that has to be repeated usually every season (6-12 months).
If the sweating is severe and does not respond to more conservative treatments, it will be necessary to consider the possibility of surgery.
What is surgery for primary hyperhidrosis?
The surgery is called sympathicotonia, and it is a minimally invasive technique that is performed with a video-assisted thoracoscopy with an incision of one cm below each axilla.
Through this incision, thanks to the help of a camera, a cut is made in the nerve chain that carries the signal responsible for excessive sweating (sympathetic chain). It is a simple intervention that lasts approximately 20 minutes, if there is a need for drainage after the operation, and that requires a hospital stay of 24 hours.
How is the postoperative hyperhidrosis?
The postoperative pain is mild and it is managed with habitual analgesics, being able to recover the patient's normal life in a few days. The results are excellent especially in the case of the palms of the hands, and very good in the case of the armpits. There is no adequate surgical treatment for excessive sweating in the feet, although treating the hands or armpits usually produces an improvement of the plants as well.
Occasionally, there may be an increase in sweating in other areas of the body to a slight degree, mainly back, abdomen or thighs, which in case of appearing is usually not annoying for patients.