Hyperhidrosis is of two types – one is Primary, Idiopathic or Focal, and the other one is Secondary Hyperhidrosis, which is unlike the primary and has an underlying disease as its cause. It is more of a symptom than a disease in itself. The sweating in this type of hyperhidrosis, unlike the primary, is not localized. There is no sweating in the sleep and the sweating is more likely to be all over rather than in one region.
A whole lot of medical conditions can cause generalized sweating. The more well-known reasons are certain medications, pregnancy, menopause, obesity, hyperthyroidism, diabetes, heart diseases, Parkinson’s disease, lymphoma, gout and the like. The preliminary diagnosis is aimed at identifying the root cause and after that necessary tests are conducted. It is, therefore, better to tell the doctor whenever a generalized excess sweating episode happens.
The general approach to treatment is try to reduce the patient’s discomfort concurrent to the investigations to ascertain the underlying cause. Antiperspirants like low strength aluminum chloride are prescribed to alleviate the discomfort of the patient, and if required prescription strength antiperspirants are used.
– Advanced treatments are available for primary hyperhidrosis. Botulinum toxin A, Botox, a nerve toxin, which can temporarily paralyze muscles had found applications in cosmetic surgery for wrinkle removal, has found applications in other areas of medical use. It has already been used in cases of axillary hyperhidrosis. A small amount of Botox is injected in about 20 or 25 spots underarm with a fine needle. The injections are generally uncomfortable and are made tolerable by the use of a fine needle. These injections give relief for more than a year. FDA clearance is limited to underarm hyperhidrosis as of now.
– Other advanced procedures are use of microwave and laser energy, which again are limited to underarm use only. The sweat glands in the underarm area are burnt using microwave energy in an hour-long operation. The skin is cooled during the treatment and a local anesthetic is used to make the operation comfortable. Laser is also used and is quicker and gives longer relief.
When all available resources have failed to give relief to the patient, a surgical procedure called Thoracic sympathectomy is tried. The sympathetic nerve in the underarm area is severed using an endoscopic instrument and is inserted between two ribs just below the armpit. The surgery though effective is considered risky. All medication and treatment options should be chosen only after consultation with a doctor.