Hyperhidrosis is characterized by excessive sweat production. It can be located in small areas, such as palms, soles and armpits, or generalized in several body areas.
Most patients are successful in treatment with topical solutions. The other cases may have the following options:
- Iontophoresis: therapy that uses an electrical device to neutralize the sweat glands using ionic currents. The patient must place the device in the affected area (palm, plant or armpit) once or twice a day for an average of 15 to 30 minutes.
- Botulinum toxin: excellent method to treat axillary, palmar, digital and plantar hyperhidrosis, however transient. It consists of the application of botulinum toxin in the affected places, through injections. The area to be treated is previously anesthetized. The toxin works by blocking nerve stimuli for the sweat glands, preventing excessive sweat production. The injection can be painful in the palmar, digital and plantar regions, but it is a safe, effective and minimally invasive treatment option. The results of treatment with botulinum toxin last an average of six months; after this period, the procedure must be repeated.
- Sympathetic nerve surgery (sympathectomy): reserved for cases resistant to other forms of treatment. It consists of cutting some sympathetic nerves to reduce the activity of the glands.
- Gland aspiration: excellent surgical alternative for the treatment of axillary hyperhidrosis using liposuction instruments. In this technique, with definitive results, the cannulas are inserted with the holes for the surface (inner face of the skin), in order to remove the sweat glands. The incisions are minimal and the resulting scars become imperceptible over time, and the patient can return to activities in three days. It is a procedure performed with local anesthesia and with little discomfort, without risk of reaching other organs.
- Microwave: the method uses a device based on electromagnetic radiation (microwave) that reaches the deepest layers of the skin, without harming the surface. While “cooking” the sweat glands, the device keeps the outer portion of the skin cool, which reduces swelling and redness in the armpits. The device also has a system that protects the superficial part of the skin, while the microwaves only act on the layer to be treated. A disposable tip is used to apply the treatment, which takes as many shots as necessary. Performed on an outpatient basis, with local anesthesia, the treatment can be used on all skin phototypes. It is more painful than axillary liposuction, but it has similar results and more comfortable postoperative.
