Hyperhidrosis is a common condition which can sometimes be treated without resorting to surgery. The condition may affect any part of the body, but is most often found in the armpits and hands. There may be a hereditary component. Once medical conditions such as diabetes and thyroid problems are excluded as the cause of sweating, your GP may prescribe topical antiperspirants. Unfortunately these preparations do not always achieve the desired results and skin reactions are common.

The armpits

Sweating here can easily be treated in most people with injections of Botulinum toxin (e.g. Botox). These can be performed in an outpatient clinic and do not require an anaesthetic. There is obviously a little discomfort associated with the injections, but nearly all of my patients have felt that this was more than compensated for by the reduction in sweating. The effect of the injections may take between 2 days and 2 weeks to show and should last between 4 and 9 months. If sweating returns, the injections can be repeated. Surgical sypathectomy (destroying the nerves that cause sweating) is also possible, but is not universally successful or satisfactory in armpit sweating.

The hands

Sweating confined to the hands or hands and armpits may be treated by surgical sympathectomy. This operation is performed under a general anaesthetic using a fine telescope placed into the chest cavity through a small cut in the armpit. The nerves causing sweating are found and destroyed permanantly. The operation is very successful but does carry some risk of complications. The risk is small, but the complications may be serious and include droopiness of the eyelid (Horner's syndrome), pneumothorax (collapsed lung) and bleeding necessitating a large incision. In some people, other areas of the body sweat more to compensate and this symptom may be very troublesome. Botox may be used to treat hand sweating but there is a risk of weakening some of the small muscles in the hand if injections are carried out too frequently.

Typical hyperhidrosis

Botox

Varicose veins Thread veins Foam sclerotherapy Sweating Hyperhidrosis Botox

Palmar hyperhidrosis