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Hyperhidrosis

What is Hyperhidrosis ?

Excessive sweating is when you sweat more than you might expect based on the surrounding temperature or your activity level or stress. Excessive sweating can disrupt daily activities and cause social anxiety or embarrassment.
Excessive sweating, or hyperhidrosis (hi-pur-hi-DROE-sis), can affect your entire body or just certain areas, particularly your palms, soles, underarms or face. The type that typically affects the hands and feet causes at least one episode a week, during waking hours.

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Excessive Sweat Causes

If heavy sweating has no underlying medical cause, it's called primary hyperhidrosis. This type occurs when the nerves responsible for triggering your sweat glands become overactive and call for more perspiration even when it's not needed. Primary hyperhidrosis may be at least partially hereditary.

If the sweating can be attributed to an underlying medical condition, it's called secondary hyperhidrosis.

Sweat Causes and Treatment Options

If an underlying medical condition is contributing to the problem, that condition will be treated first. If no clear cause can be found, treatment focuses on controlling excessive sweating. Sometimes one may need to try a combination of treatments; even if your sweating improves after treatment, it may recur.

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Treatment for excessive sweat

Oral and topical treatment

  • Prescription antiperspirant. Your doctor may prescribe an antiperspirant with aluminum chloride (Drysol, Xerac Ac). This product can cause skin and eye irritation. It's usually applied to the affected skin before you go to bed. Then you wash the product off when you get up, taking care to not get any in your eyes. If your skin becomes irritated, hydrocortisone cream might help.

  • Prescription creams. A prescription cream that contains glycopyrrolate may help hyperhidrosis that affects the face and head.

  • Nerve-blocking medications. Some oral medications block the chemicals that permit certain nerves to communicate with each other. This can reduce sweating in some people. Possible side effects include dry mouth, blurred vision and bladder problems.

  • Antidepressants. Some medications used for depression can also decrease sweating. In addition, they may help decrease the anxiety that worsens the hyperhidrosis.

Prescription Drugs
Vaccination

Non-Invasive procedure

  • Iontophoresis: The current and mineral particles in water act together to thicken the outer layer of skin, thereby blocking the flow of sweat. This is reduced to a 70% success rate for the underarms. The effects are only temporary and the treatment will need to be ongoing whilst you continue to have symptoms of hyperhidrosis. The initial treatment schedule usually involves 7 treatment sessions over a 4- week period. You will then need top-up sessions as required on a weekly to monthly basis.

  • Botox injection: Treatment with botulinum toxin temporarily blocks the nerves that cause sweating. Your skin will be iced or anesthetized first. Each affected area of your body will need several injections. The effects last 9 to 12 months, and then the treatment needs to be repeated. 

More invasive procedure

  • Microwave therapy[Miradry]. With this therapy, a device that delivers microwave energy is used to destroy sweat glands. Treatments involve two 20- to 30-minute sessions, three months apart. Possible side effects are a change in skin sensation and painful. This therapy may be expensive and not widely available.

  • Sweat gland removal. If excessive sweating occurs just in your armpits, removing the sweat glands there may help. A minimally invasive technique called suction curettage may be an option, too, if you aren't responding to other treatments.

  • Nerve surgery (sympathectomy). During this procedure, the surgeon cuts burns or clamps the spinal nerves that control sweating in your hands. In some cases, this procedure triggers excessive sweating in other areas of your body (compensatory sweating). Surgery is generally not an option for isolated head and neck sweating. A variation on this procedure interrupts the nerve signals without removing the sympathetic nerve (sympathotomy).

Surgery