Hyperhidrosis

Excessive sweating?
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Hyperdrosis is excessive focal sweating, of at least 6 months of duration, bilateral and relatively symmetric, at least 1 episode per week, it deteriorates the quality of life, it begins before age 25.

Hyperhidrosis is a condition characterized by excessive sweating in the armpits, hands, feet and face, its cause is unknown but is known to be the result of hyper stimulation of the sweat glands.

It is also considered a genetic component, given the frequent presentation in parents and children, which is consistent with a dominant autosomal hereditary pattern.

It typically begins in adolescence or as a young adult in both men and women.

Due to the intensity of the symptom, Hyperhidrosis damages personal and work activities, it is associated with a significant reduction in quality of life, comparable or worse than severe acne, pruritus or psoriasis.

Therapeutic Options:

Therapeutic options are multiple, topical agents (local action), oral medication, and surgery (Endoscopic Thoracic Sympathectomy). However, the available treatments have limitations, either short duration of effect, significant compensatory sweating, poor tolerability due to adverse effects and serious complications such as pneumothorax (in case of surgical treatment).

Blocking of nerve endings in chemical form with Botulinum Toxin Type A has emerged as a safe and effective treatment for facial and body hyperhidrosis since approximately 12 years.

When administered in areas of excessive sweating, it causes temporary denervation of the sweat glands, resulting in a local reduction of sweating for a period of 7 to 8 months.

In recent random, placebo-controlled studies conducted in Europe and the USA, it was found that more than 80% of patients had a reduction in sweating of more than 75%.

Procedure:

There is considerable variation in the size of the sweating area in the same patient (right and left) and from one patient to another. Sometimes it coincides with the axillary hair area, in other cases it exceeds it. Because of this the first step must be the marking of the area to be treated, this is achieved with the Minor Test or Iodine-Starch Test.

The area is marked with a dermographic pencil. It’s outline and on the inside it is marked with points of injection sites, generally they are 12 to 15 sites per axilla separated 1.5 cm each.

The injection should be intradermal and performed slowly. The patient should be evaluated at 10 or 15 days, in rarely occasions therapeutic response is not observed, probably because some areas were missed or the injection was performed in another plane of the skin (epidermis or hypodermis). In these cases, another Minor Test must be carried out and the untreated areas must be identified and proceed to be injected.

The patient can also be assessed with scales to measure the severity of excessive sweating (HDSS) or scales to measure the impact on the quality of life (HHIQ) (Hyperhidrosis Impact Questionnaire).

The chemical denervation of the sweat glands with Botulinum Toxin Type A is an option of value in the treatment of Hyperhidrosis, for its effectiveness and safety.

Perspiration or sweating is a function of the skin to keep our body temperature constant. However, Hyperhidrosis or unpredictable and uncontrollable excess sweating can hamper the social and work relationships of the patient.

Hyperhidrosis is excessive sweating or excessive perspiration that occurs spontaneously, without being caused by high temperatures or by situations of physical or emotional tension.

The treatment of hyperhidrosis with is a comfortable and effective solution that can be applied to both armpits as well in palms and soles.

The infiltration of Botulinum Toxin Type A is done through very fine needles. The botulinum toxin generates a blockade of the sweat glands function, reason why it reduces the production of sweat in the areas where this substance is administered.

• The treatment lasts between 40 and 60 minutes.
• Results have duration of 6 to 8 months.
• The patient can resart normal activity immediately after treatment.:

Results:

The botulinum toxin reaches its maximum effect about two weeks after the application and the treatment has shown a proven effectiveness achieving an interruption of hyper sweating in the affected area.

The effect of botulinum toxin can remain up to 8 months. However it is advisable to repeat the injections every 6 months depending on the individual characteristics of each patient.