Part III

Several patients reported difficulty with dating or even touching another person during moments of intimacy. Those with the disorder often feel compelled to explain their sweating, or create excuses to avoid physical contact or any sort of intimacy: hugging, kissing, or being sexual. Since 3 percent of the population suffer from hyperhidrosis that means with an estimated 2,290,500 weddings in the United States in 2007, approximately 137,400 brides and grooms had to walk down the aisle and worry about stains on their expensive clothing, sweat pouring down their faces during photographs, clammy hands when greeting guests and sweaty feet that may slip out of dress shoes (Know Sweat). Imagine being in a relationship where the spouse is reluctant to touch, hold, or kiss due to fear of rejection.
A 27 year–old graphic designer was interviewed, by the Columbia University Medical Center Department of Surgery, and knows all about the symptoms of hyperhidrosis. She has suffered from palmar hyperhidrosis all her life, and like many others, she also has the pair with pedal hyperhidrosis. “As far back as I can remember, I've always had sweaty hands. They were always wet and cold, and just left me feeling uncomfortable. The worst part about the condition is you can't hide it,” adds the designer. "If I was in a situation where I didn't want my hands to be sweaty, without fail they would sweat. For example, if I was going to a job interview and had to shake someone's hand, they would start sweating more." Hyperhidrosis affects one’s professional life horribly. A firm, solid handshake often makes a good first impression. This first handshake is dreaded by those suffering from hyperhidrosis because professionals may take their cold, sweaty, and clammy hands for a sign of insecurity. In a job interview this may translate, to show lack of self-confidence, which may hinder them from getting the job and achieving their goals. "Professionally, I would dread certain situations. I used to show my portfolio to get freelance work and I remember picking up the board of my artwork and there would be wet fingerprints on it. Socially things were just as bad. I remember sneaking out at weddings so I wouldn't have to shake anyone's hand at the end. I didn't even want to pick up the program at the wedding because it would be soaking wet after I touched it. My feet sweat so bad that if I was wearing shoes with leather at the bottom, the leather would turn into mud. The little things that were supposed to be fun were never fun," says the patient.
Untreated, these problems may continue throughout life. Estimates show that only 38% of those hyperhidrosis sufferers have discussed their sweating with a health care professional because many are unaware that excessive sweating is a treatable medical disorder. Treatment for hyperhidrosis can be done surgically as well as through effective medical guidance and prescription (Goyal). Treatment for hyperhidrosis can be categorized into two types; non surgical and surgical.
Non surgical treatments consist of topical antiperspirants, iontophoresis, and systemic medication. Oral or systemic medications are considered by physicians when considering treatment. Systemic medications may treat hyperhidrosis because it prevents the stimulation of sweat glands, but it is not recommended to use long term because of the serious side effects. These symptoms may include dry mouth, blurred vision, impaired speech, and urinary retention (Know Sweat). Iontophoresis works by inducing electrical changes in the sweat glands that disrupts the sweat production. This works by placing the affected area in tap water. A small electric current is then passed through the skin. This works well with mild, moderate cases of hyperhidrosis. One disadvantage for the treatment would be the time it takes to follow-through. This procedure has to occur frequently. The side effects may consist of the affected areas becoming cracked or too dry. If this does occur then it may be that the procedure is to frequent and one may need to decrease the frequencies (Hyperhidrosis).
Surgical treatments include the endoscopic thoracic sympathectomy or ETS. ETS is performed under general anesthesia through two microscopic incisions in the armpit or axilla. Through this surgery the nerve is clamped. The advantage of clamping the nerve is that if the side effects are troubling or if something goes wrong then the procedure can be reversible (The Center of Hyperhidrosis). During this surgery, CO2 is inserted into the chest to collapse the lungs which is the frightening part. This procedure can cure hyperhidrosis but has to be performed by an experienced surgeon. It may cause some increased sweating on other parts of the body.
Botulinum type A (Botox) is another popular treatment method for hyperhidrosis. Botox primarily treats axillary hyperhidrosis and is one of the most lethal poisons known, however, in low doses it can help to reduce over activity of the nerves. Botox was approved in the United Kingdom in July 2001.With the procedure small doses of Botox is injected under the arm. Clinical studies have shown that this treatment reduces the amount of sweating by 75 - 80% times. Also long-term study has shown that side effects are minimal and repeated injections over 16 months are safe and effective. In 96% of the patients, there is a 50% or greater reduction of the sweating (Hyperhidrosis-Excessive Sweating).