Treatment of Palmoplantar Hyperhidrosis

Treatment of Palmoplantar Hyperhidrosis

Palmoplantar hyperhidrosis is a violation of sweating, in which a person suffers from excessive sweating of palms and feet. Most often, the cause of the condition is high fever or stressful situations. In addition, sweating is also increased due to certain diseases.

Hyperhidrosis is not life-threatening but it can cause trouble. It is very unpleasant when the limbs sweat too much, this feature of the body often interferes with communication and can negatively affect a career or relationship. Today, excessive sweating can be treated with several methods.

Common methods of hyperhidrosis treatment

The treatment of palmoplantar hyperhidrosis only makes sense in the case of primary local hyperhidrosis. In all cases of secondary increased sweating, treatment should begin with еру treatment of the underlying disease.

Hyperhidrosis treatment methods can be divided into:

  1. External method – the use of special antiperspirants;
  2. Physiotherapeutic method – iontophoresis;
  3. Surgical methods: sumpectomy, liposuction, curettage;
  4. The hardware method – laser therapy;
  5. Injection method – the use of drugs based on BTA (Botox, Dysport, etc.).

The choice of a technique in real life often depends not only on the severity of hyperhidrosis and its localization but also on the patient’s abilities and the degree of qualification of the specialist.

Currently, there are a number of professional and effective aluminum chloride antiperspirants that narrow the ducts of the sweat glands due to the astringent action of aluminum chloride and the appearance of an insoluble precipitate at the channel of the sweat gland, which prevents sweat secretion. Antiperspirant components containing aluminum alum do not penetrate cells and do not interfere with the functioning of sweat glands. They are considered safe and effective, reducing sweating by up to 80-90%. There are antiperspirants with different concentrations of aluminum chloride – from 10-15% to 20-40%. Also, many modern antiperspirants include components that reduce the activity of bacteria that cause an unpleasant odor.

With a pronounced problem of increased sweating, the effect of antiperspirants may be negligible, however, they will ideally be suitable as additional means of eliminating the problem or to prolong the effect of another procedure.

The rule of application for all antiperspirants is general: the treated area should be dry and clean. Processing should be done at night because antiperspirants begin to act 5-8 hours after application. Do not forget that the composition of these products contains alcohol, therefore, they can cause skin irritation and itching. Do not abuse them and do not neglect the instructions and schemes proposed by the manufacturers.

Iontophoresis is the main physiotherapeutic treatment method. It is often used for palmoplantar hyperhidrosis. The method is based on the penetration of an ionized substance through an intact skin when exposed to direct current. The method is quite safe and effective. Its disadvantage is that the procedure must be repeated regularly, on average once a week. However, the market offers quite simple and convenient devices for home iontophoresis.

Surgical methods to stop hyperhidrosis are allocated in a separate group. Their effectiveness has been proven, but due to the presence of a number of disadvantages, their use is not widespread. One of the very first surgical treatments for sweaty palms and feet is sympathectomy. This is an operation on the sympathetic part of the autonomic nervous system. It is performed to eliminate the influence of the ANS on the necessary area, in particular on the axillary region with axillary hyperhidrosis. A sympathectomy is performed under anesthesia, it is quite traumatic. The operation can be irreversible (when the nerve fiber intersects completely) or reversible (when a special clip is applied to the corresponding nerve fiber, which can be removed if necessary). In addition to the disadvantages associated with the operation, sympathectomy can cause such a complication as compensatory hyperhidrosis. This is an extremely unpleasant phenomenon in the form of a significant increase in sweating in another, not operated area (for example, increased sweating in the feet after sympathectomy of the axillary region).

Liposuction surgery can sometimes be attributed to methods of treating hyperhidrosis. During the operation, a surgeon removes all subcutaneous fat with sympathetic nerves, in connection with which the nerve nodes are destroyed and sweating is reduced.

Curettage is similar in effect to liposuction: with curettage, nerve endings and sweat glands are injured at the level of subcutaneous fat, which helps to reduce sweat secretion. The disadvantages of such operations are anesthesia and high trauma. In addition, the procedure can be followed by re-growth of nerves and restoration of the innervation of sweat glands.

Laser treatment of hyperhidrosis, like iontophoresis, belongs to the group of physiotherapeutic methods but has earned a separate place in the list due to a large number of advantages. The method is based on the damage of the sweat glands of the laser beam, performed on an outpatient basis, under local anesthesia. Through small punctures in the skin (with a diameter of about 1 mm) a surgeon inserts micro-cannulas with laser optical fiber. Under the influence of the laser, the destruction of sweat gland cells occurs. The edges of the punctures are connected and sealed with a special aseptic patch, which can be removed after 3-5 days. On approximately the 7th day, all traces of the procedure pass. In one session, it is possible to reduce sweating by 80%-90%. In extremely rare cases, a second procedure is necessary. Advantages of this method: high efficiency, minor trauma, quick rehabilitation, lack of compensatory reactions. The disadvantage is the high cost of the procedure.

BTA in the treatment of hyperhidrosis

Botulinum toxin (BT) type A (BTA) is a relatively simple but effective injection method of treating sweaty palms and feet. The method is based on micro-injection into the problem area of ​​the drug, which is based on type A botulinum toxin.

Botulinum toxin was first used to treat hyperhidrosis in 1996 by subcutaneous injection for axillary and palmar hyperhidrosis. BTA drugs used to treat hyperhidrosis include Botox and Dysport.

The choice of the drug is made by a specialist (doctor) in accordance with his or her qualifications and personal preferences.

The procedure for treating hyperhidrosis begins with a survey and examination of the patient. More often, the Minor test is enough to determine the field of influence. Before the procedure, it is necessary to exclude the use of alcohol-based deodorants.

If necessary, topical anesthetics are applied to relieve the discomfort associated with the injections. The drug for administration is diluted with 0.9% sodium chloride (saline solution). The dose of a physical solution, as well as the dose required for injection, depends on the drug chosen and the recommendations of the manufacturer.

However, there is a significant relationship between the duration of the effect and the volume of units introduced: the more units are introduced, the higher and longer the effect. The maximum number of drug units in one zone is also set by the manufacturer.

Rehabilitation is usually absent. Microtraumas after injection heal during the first day, bruises – within a week.

Botulinum therapy for the treatment of palmar and plantar hyperhidrosis is less commonly used, this is primarily associated with a high degree of pain, because topical anesthetics in these areas are ineffective. However, there is a method of conduction anesthesia (median, radial and ulnar nerves), a potential complication of which may include transient weakness of the hand fingers.

Anesthesia with plantar hyperhidrosis is carried out through the posterior tibial and sural nerves.

Hyperhidrosis has a wide range of solutions, from reducing severity to its complete blockage. A doctor should only choose what is applicable in a particular situation and for a particular patient.

Recommendations after the procedure for treating hyperhidrosis

  • Do not sunbathe for 3 days,
  • Do not take antibiotics – aminoglycosides (kanamycin, streptomycin, etc.), tranquilizers, calcium preparations for 2 weeks,
  • Restrict access to the sauna, bathhouse, pool for 7 days.

You should remember that the treatment of hyperhidrosis is the same basic and necessary procedure as any other cosmetic procedures. If you suffer from excessive sweating, do not be embarrassed, you need to go to the doctor and begin treatment right away. With modern drugs and cosmetology procedures, the treatment of hyperhidrosis has become an easily solved problem.

One simple procedure for treating sweaty palms and feet relieves a person of a number of unpleasant moments when sweat interferes with normal life, eliminates the complexes associated with increased sweating and gives confidence. Do you suffer from palmoplantar hyperhidrosis? It’s time to get rid of this trouble: this disease is completely curable!