It is a disorder with a high psychosocial impact on the patient, since increased sweating in visible areas such as the face or underarms, or in areas with a lot of social activity such as hands, can cause a significant drop in self-esteem and interpersonal relations, as well as being a potential problem in the execution of some domestic or work maneuvers (shaking hands, drawing, driving, cooking, writing…).
There are numerous therapeutic options for hyperhidrosis, from topical treatments to surgery. Among the topical therapies stand out those made with aluminum chloride, which reduce the production of sweat by the glands. Iontophoresis consists in the realization of baths with a specific liquid solution and in containers that emit electrical currents that reduce the productive activity of the glands. It is an effective and comfortable therapy that the patient can perform at home if he or she acquires the medical device.
However, the treatment with better relation between risk / benefit / cost is local application of botulinum toxin. It exerts its action between the nerve fiber that transmits the activating signal and the sweat gland, reducing the number of stimuli and the intensity of the same. Thus, even if the thermal center sends signals to the glands, the former arrive in smaller numbers and magnitude. It is a very comfortable therapy, the injection of the toxin is done at different points in the affected area after applying topical or local anesthesia and the effect begins to be perceived in a few days. It is usually used to treat armpits, hands and / or feet.
Finally, there is the surgical option. In these cases a sympathectomy is performed, cutting or pinching the nerve that conducts the signal stimulating the sweat of the brain to the hands. The sympathetic nerve it’s found inside the chest and the procedure must be performed under general anesthesia by the section of Thoracic Surgery. This technique is usually used in cases where there is no response to botulinum toxin.