The secretion of sweat is controlled by the sympathetic nervous system, specifically, the thoracic sympathetic ganglion chain, which runs along the vertebra of the spine inside the chest cavity. It is believed that in some people (approximately 1% of the population), this system is working at a very high activity level, far higher than needed to keep a constant temperature. This condition is referred to as hyperhidrosis - excessive sweating.
There are two types of hyperhidrosis: primary/idiopathic (unknown cause) and secondary (known cause). Secondary hyperhidrosis can arise from various conditions, for example, endocrine disorders such as hyperthyroidism (overactive thyroid gland), endocrine treatment for malignant disease, menopause, obesity, psychiatric disorders, systemic malignant disease.
: sweaty hands (palmar hyperhidrosis), sweaty feet (pedal/plantar hyperhidrosis), underarm sweat (axillary hyperhidrosis), facial (forehead, cheeks, neck), facial blushing (Erythrophobia), flushing and cold hands (Raynaud's), truncal (trunk, buttocks), bromhidrosis (odour problems), Gustatory sweating (sweating on the forehead, face, scalp, and neck in response to eating), CS (compensatory sweating/Reflex sweating).
Topical Applications - Antiperspirants
These usually contain aluminium chloride and are often successful when used for underarm sweating.
Roll on applicator.
Roll on applicator.
Roll on applicator.
Roll on applicator.
Roll on applicator.
30% Aluminium chloride solution (or stronger)
A prescription made by a dermatologist or pharmacist.
A spray - noted to be less irritation than roll on applicators.
Roll on applicator.
The dermatolgist who developed Megadry: http://etsandreversals.yuku.com/repl...l#.UVI7QDfciyM
Alternative Topical Remedies
Products containing some chemicals other than aluminium chloride.
These are a tissue which is wiped across the area. The active ingredient is glycopyrrolate.
(bodyspray and lotion)
A spray and a facial lotion used for excessive perspiration.
Underarm roll On / Hand and foot Lotion
A product used for excessive sweating of the feet.
Topical Creams and Gels
Glycopyrrolate is an anticholinergic compound. This topical version is available in the UK from Nova Laboratories in strengths ranging from 0.01% to 10%.
Used on the feet.
A gel containing salicylic acid which is meant to enhance the penetration of aluminum chloride. The absence of ethanol may reduce irritation.
Oral medications: www.excessive-sweating.net/sweat_oralmed.html
"treatment with Ditropan XL®(i) (oxybutynin extended-release or ER), caused significant memory deterioration. Importantly, the individuals receiving oxybutynin ER failed to notice the change in their memory function. These findings were presented during the 2006 Annual Meeting of the American Urological Association (AUA)."
Article - http://www.eurekalert.org/pub_releas...-nds052306.php
- 1 mg Glycopyrrolate
- 2 mg Glycopyrrolate
(Glycopyrrolate) - ranging from 0.5 mg - 2.0 mg
Beta-blockers may be helpful when history indicates that symptoms are precipitated or exacerbated by stress.
This involves placing the hands and/or feet into shallow trays filled with water, whilst a small electrical current is passed into metal plates and the water. After initial treatments dryness can last for up to 3 weeks in applied areas. Maintenance treatments should be carried out as required to maintain dryness.
The water in your area can affect the effectiveness of the treatment. Hard water contains more minerals which are an important factor. To increase effectiveness with soft water, baking soda or sea salt can be added.
Studies show Iontophoresis with 0.05% glycopyrronium bromide solution (Glycopyrrolate) (or a stronger concentration) to be significantly superior to tap water in suppression of palmoplantar hyperhidrosis.
This solution can be used when tap water iontophoresis is unsuccessful. The solution can be re-used a few times. It can be ordered on prescription in the UK from Nova Laborotories.
Anticholinergics are a class of medications that act by preventing acetylcholine from stimulating receptors on the sweat glands. In this way, anticholinergics shield the sweat gland from the action of acetylcholine. One anticholinergic, glycopyrrolate, is unlike most others in that it does not cross the blood brain barrier and is therefore less likely to produce certain side effects.
Possible Future Treatment Administering botox by iontophoresis
This treatment is still in it's early stages. The case study reports it "can be effective up to 3 months with only one treatment".
The case study: http://sweathelp.org/pdf/BTX_ionto_Br_J-Derm_2004_.pdf
Drionic instruction manual: www.flickr.com/photos/dryconfidence/6134275872/
Customising the Drionic: www.oocities.org/drionicmods/index.html
(Includes an order form to buy the machine at a reduced price of $100)
Idrostar instruction manual: http://www.iontophoresis.info/wp-con...nual.Jan10.pdf
R.A. Fischer, MD-1a
R.A. Fischer company: www.rafischer.com/
Unit instructions: www.rafischer.com/share/md1a-manual.pdf
Usage manual: www.rafischer.com/share/md1a-usage.pdf
A prescription is needed to purchase the Fischer.
Idromed 4 / 5
Idromed 4 operating instructions: http://beatpsoriasis.com/forms/idromedGS.pdf
Review of the Idromed: www.no-ets.com/idromed-hyperhidrosis.html
It has been noted that some Idromed 4 machines are 110V so a step up converter may be needed (US and UK mains are 230V/240V).
IONTEX 3, IONTEX S
Botulinum toxin injections. This is mainly for underarm sweating. The anhidrosis effect usually begins to weaken in 4-6 months.
Electrolysis is used for permanent hair removal. A needle is inserted into into the skin and an electrical current destroys the follicle, but the sweat gland can also be destroyed itself.
Clothing and dress shields are available which prevent sweat soaking through into clothes.
Try experimenting by cutting out certain foods (consult a doctor first).
Dried Sage leaves
Herbal medicines may help. It is best to consult a professional.
Learning how to deal with anxiety and cope in stressful situations may help.
Anxiety relieving medications
This could help if a patient has a history of anxiety which triggers sweating.
Homeopathic Formula for Symptoms of Excessive Perspiration
COREcontrol to help thermoregulation
As the video on the website shows you would put your hand in the machine and it would work to reduce hot flushing or the general feeling of being too hot.
"Dry Type" Iontophoresis
A new iontophoresis device was manufactured which did not use tap water to control sweating.
Electrical stimulation of the sympathetic nervous chain
A proposed method of treating palmar hyperhydrosis by 'applying an oscillating electric field to the stellate ganglion'.
A UCLA study in 2002 suggests a strong genetic link to hyperhidrosis.
Growing stem cells to repair the damaged sympathetic nervous pathway in ETS patients who suffer with negative side effects.
Endoscopic Thoracic Sympathectomy. This is generally considered the last resort
due to a wide range of possible, sometimes severe side effects. In general terms ETS does not offer a true cure for Hyperhidrosis, but usually moves sweat from one area to another - referred to as reflex sweating. Side effects may be much more serve than this (see ETS & reversals forum link below).
Sympathectomy is performed through small keyhole incisions in the underarm area under general anesthesia. Certain sympathetic nerve ganglia are cut at the 'T1'-'T5' levels in the thoracic cavity depending on the type of hyperhidrosis in question, thus interrupting the nerve signals which ordinarily would stimulate the body's fight-or-flight response.
Another method is ESB/ETS C (endoscopic sympathetic blockade, or sympathectomy clamping method) - clamping the nerves instead of destroying them. This method is to theoretically allow the nervous chain to be restored to its origional state by removing the clamps if undesirable effects develop, or reconstructing the nerve in the future. After quite a short period of time people have reported the sympathetic chain cannot be restored regardless of removing the clamps.
In 2003, ETS was banned in its birthplace, Sweden, due to overwhelming complaints by disabled patients. In 2004, Taiwanese health authorities banned the procedure on patients under 20 years of age.
From wikipedia - http://en.wikipedia.org/wiki/Endosco..._sympathectomy
About ETS: http://www.sweathelp.org/English/HCP...TS_Surgery.asp
Possible side-effects with surgery:www.no-ets.com/sideeffects.html
Pulse radio frequency sympathectomy
The sympathetic nerve is 'zapped' with radio frequencies, instead of being cut or burned as in ETS. The nerve is suppost to grow back, but slightly different to before.
This procedure involves the use of needles to make a puncture through the upper back, using CT guidance a phenol-based medication is injected. This interrupts the nerve tracts and nodes that transmit signals to the sweat glands. As with ETS this procedure should be used as a last resort.
Discussion - http://etsandreversals.yuku.com/forum/viewtopic/id/1915
Excision (Skoog Procedure), Curettage, Axillary Liposuction
"Curettage and Liposuction are similar. With curettage the sweat glands under the skin are removed by scraping. Liposuction removes glands by suction. Curettage is more effective than liposuction as many of the glands are left behind by suction and grow back within 6 months".
The Skoog procedure involves incision and dissection to expose the glands on the underside of the skin. The glands are surgically removed using fine scissors under magnification. The scars are more noticeable with this procedure but it seems to be more effective in making sure all the glands are removed.
Information on procedures: http://www.emedicine.com/plastic/topic530.htm
Doctor's website: http://www.sweaty-armpit.com/bromhidrosiscure.html
Useful Forums and websites
ETS & Reversals Discussion Forum
ESFB Channel Discussion Forum
International Hyperhidrosis Society
pubmed medical articles
Hyperhidrosis on YouTube
Hyperhidrosis support group
Very good Forum
- 'Sweaty Betty' Forum
- Teen Hyperhidrosis Forum
Wet Hands Club Forum
Wet Hands Club
HH support Forum
The Effects of Thoracic Sympathectomy
Truth about ETS
Includes videos of botox