At Home Christian Jessen 2014 - 117

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HyperHidrosis (excessive sweating)

As research into treatment continues, you can get to grips with this condition
Interestingly, facial blushing and
hyperhidrosis, usually of the hands, are
linked. There is no medical or anatomical
reason for this that is clearly understood.
However, in Mr Paes' experience, those
who have severe facial blushing tend
to have some degree of sweating of their
hands and vice versa.
The most common sites of problems from
hyperhidrosis are the face, axillae (armpits)
and hands. Sweating of the feet, while it
can be a bit of a problem, is not a social
embarrassment as in most cases it is not
obvious due to wearing socks and footwear.
Facial sweating is the main problem,
closely followed by hyperhidrosis of the
armpits and then the hands.

over-30s it tends to dwindle to around 60%.
However, it is not possible to predict by a
blood test - or any other means - what
result is likely to happen in any individual.

ETS controversy

The second issue with ETS is that of
compensatory hyperhidrosis (excessive
sweating). 'Again, this is not a side effect
that can be predicted in any individual but,
in our studies, between 2% and 5% of
patients wish they had not had the operation
for that very reason,' says Mr Paes.
'Compensatory hyperhidrosis tends to
affect the trunk and lower abdomen and, in
extreme cases, can necessitate a change
in clothing two to three times a day.' In
many centres internationally, ETS is now
performed simply by destroying the second
thoracic ganglion and this has, to some
extent, reduced the level of compensatory
sweating, although it still does occur. 'In our
experience, it is best left for those people
who seek a treatment for their facial blushing
to go through the first two levels before
embarking on an operation, as they may

Hands on
Most facial hyperhidrosis comes from
the top of the forehead and then drips
down the face. In experts' experience,
Botox® injections to the forehead tends
to reduce the problem for those who suffer
from the condition by around 50%.
Axillary hyperhidrosis (excessive armpit
sweating) is extremely well treated by
Botox® injections, and this is now the
treatment of choice for sweating in this
area. Hyperhydrosis of the hands is a
problem, particularly in those who use their
hands as part of their everyday work. This
includes schoolchildren who find that writing
exam papers or any schoolwork can be a
big issue because the paper gets wet. It also

not need an operation if one of the other
treatments has helped them,' says Mr Paes.

Below the face

'We have also done considerable research
on neck blushing. This is a particular problem
in women who wear low cut dresses or
clothing without a collar. It is particularly
embarrassing because it is more obvious
since it is a stippled (small patches) blushing
rather than an overall redness of the skin.
Our established expertise in the field of

affects those who play instruments and, in
particular, people who use a keyboard.
The social embarrassment arises from
circumstances in which the individual
affected is in a position where he has to
shake hands with, for example, a client
during a meeting or a new friend.
In general, palmar hyperhidrosis is
not effectively treated by Botox® injections
since it is extremely painful and the required
frequency of this treatment is rarely
satisfactory. Topical preparations tend to
cause rashes. Endoscopic transthoracic
sympathectomy tends to be the best
treatment, since it is 99.5% successful.
Feet first
Plantar hyperhidrosis (sweaty feet),
again, is not really well treated by
Botox® injections and - in Mr Paes'
experience - ionophoresis is probably
the best symptomatic treatment.
'While iontophoresis, which involves
using an electric current can help, it is
not so effective in our experience as
in palmar hyperhidrosis,' says Mr Paes.
'However, it would be considered a first
line of treatment and iontophoresis units
can be purchased fairly cheaply by the
patient. We have also published papers
in medical journals regarding hyperhidrosis
of the nose where Botox® injectables have
been very effective. We are constantly
researching new and more effective forms
of treatment for blushing and sweating.'

facial blushing ensures that we map out the
best treatment pathways and advice for
any individual rather than pooling them into
a statistical group.'

FOR MORE INFORMATION
Visit www.sympathectomy.co.uk

s y m pat h e c t o m y


http://www.sympathectomy.co.uk

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