Stop Sweating Questions, Remedies And Solutions
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does anyone know if there is simple treatment for it, like an operation, i dont want botox! because my doctor keeps saying that their is no treatment for it, and i dont belive her! And if there is an operation, could you have it done at like a hospital, or do i need a specialist or something?
Tagged with: botox
Filed under: Hyperhidrosis
Hair removal (1)
Goto a specialist
WHAT IS THE TREATMENT FOR HYPERHIDROSIS?
The initial treatment for hyperhidrosis is usually medical and does not involve surgery. There are ointments and salves available (i.e., Drysol) that are astringents that tend to dry up the sweat glands. Another treatment is iontopheresis. This consists of a treatment of electrical stimulation, usually in the hands. Patients place their hands in a bath through which an electrical current is passed. This treatment tends to "stun" the sweat glands and can decrease the secretion of sweat for periods of 6 hours to one week. One of the most recent treatments proposed is the injection of botulinum toxin (Botox) into the area of excessive sweating. This is a toxin that affects nerve endings and decreases the transmission of the nerve impulses to the sweat glands thus resulting in decreased sweating. It generally requires several injections in the palms or underarms and it remains effective from one to six months. Repeated injections are nearly always required to maintain an adequate level of dryness.
In addition to the above treatments, many medicines have been utilized with varying success. These include both sedatives (in those patients with stress-induced hyperhidrosis) and medications that affect the nervous system. A family practitioner or internist often begins the initial treatment for hyperhidrosis. Cases not responding to simple treatment regimens are often then referred to a specialist such as a dermatologist or neurologist. In general, surgery is contemplated only when the less invasive medical treatments have failed to provide adequate treatment.
WHAT SURGERY IS PERFORMED TO TREAT THIS CONDITION?
The surgical treatment of hyperhidrosis involves destroying or removing a specific portion of the main sympathetic nerve. As noted above, the sympathetic nerves are part of a separate and parallel nervous system. Their anatomic location is separate from the somatic (voluntary) nerves that control sensation and motor function. The sympathetic nerve "chain" is formed by a plexus of nerves located next to the ribs in the chest. The spine is made up of vertebra, which are blocks of bone stacked one on top of another like building blocks. The branches that form this sympathetic "chain" come from between these building blocks and end in a bundle of cells called a ganglion. There is a ganglion at each vertebral level of the spine and all these ganglions are attached one to another longitudinally to form the "sympathetic chain." A sympathetic nerve branch then comes off each of these ganglions and travels out to enervate blood vessels and sweat glands in the body. The surgical therapy for hyperhidrosis entails removing or destroying the specific ganglion that cause sweating in the arm and the axillae. There are a variety of ways of dealing with the sympathetic ganglions including removing them, cauterizing them, cutting the branches, and clipping them. Different surgeons have been trained in different techniques and all appear to be effective in a high percentage of cases. No specific technique has proven definitively to be superior to the others.
In order to treat palmar (hand) hyperhidrosis, the T2 ganglion is removed or destroyed. Many surgeons will also remove the third ganglion to maximize the chance of completely preventing sweating of the hands. In order to treat the armpit, the second and third ganglia are removed or destroyed. Similarly, some surgeons will also destroy the fourth ganglion to once again maximize complete relief from armpit sweating.
In the past, this often required a moderate to large sized incision in the chest which required cutting muscles and separating ribs to expose the sympathetic chain. However, recent advances in technology have produced less invasive methods, such as the so-called endoscopic thoracic sympathectomy (ETS), also known as thoracoscopic sympathectomy. This entails general anesthesia for the patient. Once asleep, two or three small (5-10 mm) incisions are made below the armpit. Through these holes, a telescope is passed which is attached to a miniature video camera. Thus, the sympathetic chain can be identified. Through the remaining one or two incisions, instruments are placed to allow the surgeon to remove or destroy the specific ganglions as dictated by the patient’s symptoms. To perform this operation, the patient’s lung must be collapsed to allow adequate space for the surgeon to maneuver. Following completion of the operation, the lung is re-expanded and the incisions are closed. Occasionally a small tube is left inside the chest to allow evacuation of air, however, this is usually removed within hours of the surgery. After one side is completed, the surgeon then turns his/her attention to the opposite side and an identical procedure is performed.
Typically, the patient remains in the hospital for a period of 12-24 hours following surgery. There is post-operative pain following surgery and most patients will require some oral pain medication for a period of 7-10 days following surgery.