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What is hyperhidrosis?

Hyperhidrosis is a chronic medical disorder that causes excessive sweat production in areas of the body such as the hands, feet, or, in this case, armpits. The affected person’s quality of life is compromised so much so that one in three people with hyperhidrosis surveyed said that their sweating was intolerable or barely tolerable. Many patients said they were depressed and frustrated on a daily basis, and that it interfered with their work and personal lives.

What is plantar hyperhidrosis?

Plantar hyperhidrosis, tends to first appear during puberty and early adolescence, causing a great social, psychological, emotional, and physical decline in those affected due to its visibility and the inability to hide it.

Treatments for plantar hyperhidrosis

Illustration of the sweat glands

Illustration of the sweat glands

It is recommended to try the less invasive options, antiperspirants and iontophoresis, first. If after learning how to use these treatments more effectively there is still no relief, then botox treatments may be considered. This treatment is exclusive for this particular type of hyperhidrosis.

Oral medications are not recommended as a long-term solution due to their side effects, and surgical options, although very popular, are reserved for severe cases of hyperhidrosis that have not responded to other treatment options.

  • Antiperspirants:

This is the first option recommended by dermatologists as these are the least invasive treatment to stop armpit sweating. In addition, no prescription is necessary for these products. Some of them also act as deodorants to reduce odours.

  • Botox injections:

After evaluation and approval by a dermatologist, this treatment uses a very fine needle to inject small amounts of the botulinum toxin just under the armpit skin, near the sweat glands responsible for excessive perspiration. In order to alleviate the discomfort produced during treatment, doctors can use anaesthetic techniques such as analgesic creams, nerve blocks, ice, or vibrations.

There is a possibility that some sweat glands may be overlooked during these procedures. If this occurs, it is important that you talk to your doctor to reassess the areas of sweating and perhaps “fill” the gaps with additional injections. Botox injections, therefore, do not cure hyperhidrosis; they only eliminate the problem for a while. After that period, the symptoms gradually reappear and require follow-up injections at varying intervals (seven to 16 months) to keep the area dry.

  • Oral medications:

Anticholinergics, beta blockers, and clonidine hydrochloride are some of the medications that have been tried.

Theoretically, these medications could help treat excessive sweating as they prevent the stimulation of all sweat glands and therefore may limit sweating in general. However, long term use is not recommended due to some serious side effects.

  • Surgical treatments:

After all of the above treatments have been tested, adapted to individual circumstances, and still prove to be ineffective, your dermatologist may consider surgical treatment as a solution for excessive sweating. There are different types of surgery to treat hyperhidrosis. In some surgical procedures, sweat glands are eliminated and endoscopic thoracic sympathectomy (ETS). ETS, in particular, is considered a last resort since it often causes serious, irreversible sweating. ETS surgery is not usually recommended because of its very negative potential side effects.

  • Everyday solutions:

Although only a doctor can prescribe or perform certain hyperhidrosis treatments, there are things you can do to help make excessive sweating only a minor burden in your daily life:

  • Bathe daily to control the amount of bacteria on the skin.
  • Dry well after bathing. Bacteria and fungi (which can cause bad odour and infections in irritated skin) grow in moist places, such as the armpits.
  • Apply antiperspirants twice a day, in the morning and the afternoon. Or, if you are using an antiperspirant once a day, apply it at night rather than in the morning. If you are using a prescription or a high-potency antiperspirant, follow your doctor’s instructions and remember that these products may damage your clothing and bedding.
  • Choose air-permeable clothing. Use natural fabrics such as cotton, wool, and silk, which allow the skin to breathe. When exercising, you may prefer high-tech fabrics that absorb moisture from your skin.
  • Dress shields, small cushions that go under the armpits to absorb sweat, may be an option. You can also bring an extra clean shirt in case of emergency.
  • Wash clothes frequently and change your clothes often.
  • Avoid hot drinks (coffee), alcohol, and spices, which can make you sweat.
  • Try relaxation techniques like yoga, meditation, or biofeedback. These can help you learn how to control the stress that can lead to perspiration.
  • Change your diet Take note of any food or drink that makes you sweat more than usual. Consider the possibility to eliminate caffeinated beverages as well as alcohol, certain “hot” spices, and foods with strong odours such as garlic and onions.
  • Join a support group or discussion forum on the Internet such as the International Hyperhidrosis Society.

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Diagnosis and treatment of plantar hyperhidrosis in Valencia

• Dr. Gabriel Serrano Sanmiguel

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