Humans sweat to regulate our body temperature.In addition, heat, intense physical exercise or even eating spicy foods are events that can increase our sweating rate. Although it may not seem like it, a healthy individual sweats an average of 1 liter of liquid per day, but since most of the sweat evaporates, we do not perceive it.
Depending on the areas that perspire this mixture of water, mineral salts, lactic acid and urea, we can differentiate three types of sweating: palmar, axillary and facial. Some places produce this type of fluid more frequently than others, as many of us are more familiar with axillary sweating than palmar or facial sweating, for example.
Even so, a certain percentage of the population experiences atypical sweating patterns: this is the case of hyperhidrosis. Fortunately, there are surgeries that, effectively, end this clinical picture in 95 % of the cases.. Stay tuned if you suffer from hyperhidrosis, because we assure you that your condition has a solution.
What is hyperhidrosis?
Hyperhidrosis is defined as abnormal or excessive sweating that does not necessarily correspond to high temperatures or physical exercise. In these cases, the body produces sweat as a response to environmental conditions or emotional stimuli that greatly exceed the physiological ones.
A patient with hyperhidrosis will sweat from the feet, armpits or hands even in air-conditioned environments, where it is not normally expected. This, naturally, entails serious psychological, social and professional dysfunctions: the fear of shaking hands with a boss and having him or her drenched in sweat is certainly a fear that all people with hyperhidrosis will identify with.
The causes of primary hyperhidrosis (not due to medical conditions such as infection, for example) are unknown, as the patient’s sweat-producing glands are completely normal. Even so, the nerves responsible for sending them the signals that promote perspiration become hyperactivedespite having received no stimuli indicating the need for it. It is believed that this condition may have some hereditary component.
Finally, as far as terminology definition and epidemiology are concerned, we think it would be interesting to show you some data collected by several studies:
- In the U.S. population, the prevalence of hyperhidrosis (number of people affected in the population) is 2.8%.
- In certain specific areas of China, this value increases dramatically, to 4.6%.
- Overall, it is estimated that hyperhidrosis affects 1- 3% of the population worldwide.
With this data we want to make one thing clear: you are not alone. This condition is relatively common and can be tremendously annoying from a social and professional point of view, which is why wanting to seek solutions is more than justified. 3 out of 100 people suffer from it.
Various medical portals also emphasize that hyperhidrosis goes far beyond excessive sweating. Excessive sweating can generate various responses in the patient. Some of them are the following:
- Modification of habits and difficulty in performing certain tasks (fear of exercising, changing clothes to try to avoid sweating…etc).
- Discomfort and discomfort.
- Low self-esteem and problems in establishing social relationships.
- Skin blisters and secondary infections due to overly moist skin.
A patient is considered to have primary hyperhidrosis when this abnormal sweating occurs at least once a week. occurs at least once a week, during the day and usually on both sides of the body.. It should be noted that this event should not be confused with secondary hyperhidrosis, a sweating that is due to a disease (diabetes, menopause, infections or some types of cancer, among others).
In the following sections, we will tell you how the surgery that solves hyperhidrosis works.
Hyperhidrosis surgery: a definitive solution
As mentioned above, surgery effectively ends sweating in 95% of cases. Unfortunately, it is a slightly more invasive procedure than the patient might expect, as it involves going into the operating room and giving the client a general anesthetic for 1-3 hours.
The procedure: endoscopic thoracic sympathectomy
The procedure, known as endoscopic thoracic sympathectomy, is generally as follows. First, the professional must make 2-3 cuts in the axillary area on the side of the body where excessive sweating is occurring. The lung on this side should be deflated (collapsed), as this will allow the practitioner to act much more comfortably and perform the necessary tasks on the patient.
After the cuts and lung collapse, the practitioner will insert a tiny camera into the chest, as this video thoracoscopy (VATS) assistance will allow him to identify the nerves that control sweating in the problem area.. Once detected, they will be cut, clamped, or destroyed.
This is the really key step of the operation, because if there is no nerve stimulation, the eccrine glands stop producing excessive sweating in the hands (or the area of interest). Once the procedure is completed, the lung is reinsulphated and the same procedure is performed on the other side of the body. To check for proper lung expansion, a precautionary chest x-ray is performed and, if all is well, the patient can return to his or her room in the hospital facility.
Usually, a few hours after the operation, a normal diet is restored and the individual is encouraged to move around in order to obtain a faster recovery. After 24 hours, the patient is ready to return home.
It should be noted that, as invasive as this surgery may seem, contraindications are few, contraindications are few and the individual will be able to return to normal life as soon as the pain subsides, i.e. a few days after the operation. The patient will have to wait about 10-15 days to exercise, although he will be able to return to work as soon as his body allows him to do so.
On the other hand, it is also necessary to emphasize that there is another alternative to endoscopic thoracic sympathectomy. The patient can opt for an injection of botulinum toxin (botox), which blocks nerve transmission without the need to cut the nerve. The catch? It is temporary, as it lasts for about 6-8 months.
Portals that perform endoscopic thoracic sympathectomy (such as the FAVALORO foundation) warn us that there is a relatively common side effect of the surgery: compensatory sweating. relatively common side effect of the surgical procedure: compensatory sweating..
Unfortunately, the patient’s body may “decide” to sweat exaggeratedly in another area of the body once the overactive nerve causing the problem has been cut. For example, if the individual had hyperhidrosis in the palm of the hand, after surgery he or she may sweat exaggeratedly in the palm of the foot. This sweating can be mild or severe and it is not possible to predict whether or where it will occur. It is up to the patient to weigh the probabilities of this event and what they entail.
Other medical portals list other possible adverse effects of greater concern: accumulation of blood or air in the chest, damage to arteries or nerves, decreased heart rate or pneumonia. As strange as these events may be, it is our obligation to report them.
As you can imagine the possible side effects of botox treatment are much smallerThe procedure is less invasive and is based on a series of injections that take about 20 minutes, which can be performed at the dermatologist’s office. Unfortunately, as we have already said, this is a temporary solution.
Endoscopic Thoracic Sympathectomy usually costs around 4,000 euros ($4,750), while Botox injections can be administered for around 400 euros ($475). In effect, the surgical procedure costs 10 times more than the dermatological procedure.
It is all a matter of weighing the pros and cons of each of the options: thoracic sympathectomy is for life, whereas botox is used at specific time intervals of interest to the patient or, in the long run, with multiple interventions in the dermatology clinic.
As we have seen, there are three possible solutions to hyperhidrosis: living with it, undergoing surgery or a series of injections at the dermatologist. Of course, the last of these seems the most seductive but, if the patient wants to address the condition permanently, endoscopic thoracic sympathectomy is a must.. We have informed you, from here on, it is up to you to decide.