Hyperhidrosis: Evolving Therapies for a Well-Established Phenomenon

Eisenach, John H.; Atkinson, John L. D.; Fealey, Robert D.
May 2005
Mayo Clinic Proceedings;May2005, Vol. 80 Issue 5, p657
Academic Journal
The socially embarrassing disorder of excessive sweating, or hyperhidrosis, and its treatment options are gaining widespread attention. In order of frequency, palmar-plantar, palmar-axillary, isolated axillary, and craniofacial hyperhidrosis are distinct disorders of sudomotor regulation. A common link among these disorders is an excessive, nonthermoregulatory sweat response often to emotional stimuli in body regions influenced by the anterior cingulate cortex as opposed to the thermoregulatory sweets response regulated by the preoptic-anterior hypothalamus. Diagnosis of these mechanistically amblguous disorders is primarily from patient history and physical examination, whereas results of laboratory studies performed with indicator power reveal the distribution and severity of resting hyperhidrosis and document the integrity of thermoregulatory sweating. Treatment options lie on a continuum based on the severity of hyperhidrosis and the risks and benefits of therapy. In general, therapy begins with antipersplrants or anticholinergics. Iontophoresis is available for palmariantar and axillary hyperhidrosis. Botullnum toxin type A or local excision/curettage is effective for isolated axillary hyperhidrosis not responsive to topical application of aluminum chloride. Endoscopic thoracic sympathectomy may be used for severe cases of palmar-plantar and palmar-axillary hyperhidrosis. No sole therapy of choice has emerged for craniofacial sweating. The long-term sequelae of hyperhidrosis and its treatment also are discussed.


Related Articles

  • Transthoracic Endoscopic Sympathectomy for Craniofacial Hyperhidrosis: Analysis of 46 Cases. Torng-Sen Lin; Hsin-Yuan Fang // Journal of Laparoendoscopic & Advanced Surgical Techniques;Oct2000, Vol. 10 Issue 5, p243 

    Investigates whether transthoracic endoscopic sympathectomy of the lower part of stellate ganglion is efficient and safe in the treatment of craniofacial hyperhidrosis. Definition of idiopathic hyperhidrosis; Distribution area of compensatory hyperhidrosis; Information on compensatory...

  • Hyperhidrosis. Piercy, Jo // BMJ: British Medical Journal (International Edition);5/14/2005, Vol. 330 Issue 7500, p1127 

    Presents instructions on how to diagnosis hyperhidrosis. Description of a woman whose symptoms include profuse sweating; Suggestion to identify the exact locations of the sweating and determine the severity; Tips for how to treat the patient, including discussing medications and what options may...

  • Endoscopic thoracic sympathectomy for primary hyperhidrosis: A 16-year follow up in a single UK centre. Cameron, A.E.P.; Connery, C.P.; De Campos, J.R.M.; Hashmonai, M.; Licht, P.B.; Schick, C.H.; Bischof, G. // Surgeon (Elsevier Science);Feb2014, Vol. 12 Issue 1, p59 

    A letter to the editor is presented in response to the article "Endoscopic thoracic sympathectomy for primary hyperhidrosis: A 16-year follow up in a single UK centre," by A. E. P. Cameron and colleagues in the 2014 issue.

  • An assessment of anxiety in patients with primary hyperhidrosis before and after endoscopic thoracic sympathicolysis. Ramos, Ricard; Moya, Juan; Morera, Ricard; Masuet, Cristina; Perna, Valerio; Macia, Ivan; Escobar, Ignacio; Villalonga, Rosa // European Journal of Cardio-Thoracic Surgery;Aug2006, Vol. 30 Issue 2, p228 

    Abstract: Objective: Endoscopic bilateral thoracic sympathicolysis (EBTS) is an effective and minimally invasive procedure used for patients with primary hyperhidrosis. The purpose of this study was to examine anxiety levels using standardized psychometric tools in hyperhidrosis patients before...

  • Clinical, Magnetic Resonance Imaging, and Electroencephalographic Findings in Paraneoplastic Limbic Encephalitis. Lawn, Nicholas D.; Westmoreland, Barbara F.; Kiely, Michael J.; Lennon, Vanda A.; Vernino, Steven // Mayo Clinic Proceedings;Nov2003, Vol. 78 Issue 11, p1363 

    • Objective: To analyze clinical presentation of and paraclinical test abnormalities in patients with paraneoplastic limbic encephalitis (PLE). • Patients and Methods: We retrospectively reviewed 24 patients seen at the Mayo Clinic in Rochester, Minn, between 1985 and 2002 in whom...

  • Video-Assisted Thoracoscopic T[sub2] Sympathetic Block by Clipping for Palmar Hyperhidrosis: Analysis of 52 Cases. Lin, Torng-Sen; Huang, Ling-Chu; Wang, Nai-Phon; Lai, Chung-Yow // Journal of Laparoendoscopic & Advanced Surgical Techniques;Apr2001, Vol. 11 Issue 2, p59 

    Background: Endoscopic thoracic sympathectomy or sympathicotomy is a standard method in treating palmar hyperhidrosis, but postoperative compensatory sweating may be troublesome in some patients. Therefore, we designed a new technique for only T[sub 2] sympathetic blocking by clipping instead of...

  • Intrapleural analgesia following thoracoscopic sympathectomy for palmar hyperhidrosis. Assalia, A.; Kopelman, D.; Markovits, R.; Hashmonai, M. // Surgical Endoscopy;Jun2003, Vol. 17 Issue 6, p921 

    Background: Reports on intrapleural analgesia (IPA) are conflicting. The current study assessed the effect of a single-dose thoracoscopic bilateral intrapleural anesthetic administration on the immediate postoperative recovery room and 24-h pain control. Methods: Fifty patients with primary...

  • The importance of classification in sympathetic surgery and a proposed mechanism for compensatory hyperhidrosis: experience with 464 cases. Chou, S.-H.; Kao, E.-L.; Lin, C.-C.; Chang, Y.-T.; Huang, M.-F. // Surgical Endoscopy;Nov2006, Vol. 20 Issue 11, p1749 

    Background: Compensatory hyperhidrosis is the most troublesome side effect and the leading cause of regret with sympathetic surgery. A new classification is proposed to make the procedure more selective and to minimize the side effects and regret rate. Also, a proposed mechanism for...

  • Endoscopic Transthoracic Sympathectomy with a Fine (2-mm) Thorascope in Palmar Hyperhidrosis: A Case Report. Okura, Toshihiko; Suzuki, Takashi; Suzuki, Shuichi; Kitami, Akihiko; Hori, Goichi // Journal of Laparoendoscopic & Advanced Surgical Techniques;Jun98, Vol. 8 Issue 3, p161 

    Presents a case of endoscopic transthoracic sympathectomy using a fine thoracoscope in palmar hyperhidrosis. Medical history of the patient; Comparison of preoperative with postoperative thermography; Reason the fine thorascope is unlikely to interfere with the manipulation of instruments.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics