Sweating and available treatments
Hyperhidrosis is a condition of excessive sweating in certain areas of the body. Axillary hyperhidrosis refers to severe sweating under the arms, while excessive sweating without any underlying medical condition is called primary hyperhidrosis. If the cause of excessive sweating is due to a medical condition, this is referred to as secondary hyperhidrosis.
Hyperhidrosis is caused by overactive sweat glands where increased release of acetylcholine – a chemical from the central nervous system that directs the sweat glands to produce sweat – causes excessive perspiration. Hyperhidrosis may significantly affect the social and psychological wellbeing of an individual. It may cause physical discomfort, social embarrassment, affect occupational and daily activities and, at times, may also cause social isolation. Several options are available for treatment of hyperhidrosis.
Antiperspirants/deodorants: Some deodorants block the sweat pores while deodorants help control body odour. Unfortunately, these agents may also cause irritation and itching of skin in some individuals.
Medications: Agents that inhibit the release of acetylcholine such as glycopyrrolate (Robinul, Robinul-Forte). These agents may cause drymouth, dizziness and other side effects.
Iontophoresis: A small electrical current is used to temporarily block the sweat glands. This is often used for treating excessive sweating of the palms and soles of the feet. A drawback with ionotophoresis is that the results are temporary, require multiple sessions every week and the procedure cannot be used for underarm sweating.
Surgery: Surgery may be performed to remove the sweat glands or to interrupt the impulses from the central nervous system in a procedure called endoscopic thoracic sympathectomy (ETS). The ETS procedure is considered a last resort as it can cause a side effect of compensatory sweating that can be even worse than the original problem.