Bridges Medical Clinic
5601 Norris Canyon Road Suite 240
San Ramon CA 94583
Tel: 925-975-3353
drsolomon@bridgesmedical.com
Excessive Sweating (Hyperhidrosis):
As a previous long
time sufferer of excessive underarm sweating, I can relate to the embarrassment
of staining clothes, being unable to wear certain color and types of clothes
and the feeling of being damp all the time. The different ways to treat
this is the past have been:
Antiperspirants:
over the counter types never seem to do the job. Prescription antiperspirants,
such as Drysol and Maxim seem to burn and are very irritating and never
seemed to keep me dry.
Anticholinergics: These are prescription medications such as Robinol
and Ditropan. They work best in cases of people who have sweating in large
areas of their body that cannot be treated with Botox, such as the scalp
under the hair or the abdomen and back. Unfortunately, the dryness that
they produce is very variable and is dose related. About 60% of people
have complaints of very dry mouth that in some cases cannot be tolerated.
Some other side effects are headaches, constipation, sleepiness, blurred
vision and urinary retention.
Iontophoresis: This is used to treat the hands and feet mostly and uses a machine that sends a mild current of electricity to the skin. You need to use this machine for about 20 minutes 2-4 times per week and purchase the machine. The results of using this are mixed.
Endoscopic Thoracic Sympathectomy: This technique is relatively new and involves a surgical procedure whereby, under general anesthesia, the surgeon places three small endoscopes into the chest wall and cuts, burns or clips the thoracic sympathetic ganglia at the T2 and T3 level for hand sweating and T4 for underarm sweating. The results of this show that about 90% obtain dryness of the hands when T2 and T3 are damaged, but only about 60% get dryness under the arms when T4 is added. The complications can be bleeding, requiring conversion to open thoracotomy, hemo-, pneumo- and chylothorax, pleural adhesions or effusion, peripheral nerve injury, chronic postoperative pain, complete or incomplete Horner's syndrome. The most troubling complication is that of compensatory sweating in the back and abdomen that can be worse than the original problem. It seems that over 50% of the people can suffer from this.