Several different approaches have been taken to cure this very socially and functionally embarrassing problem. Patients have tried everything from herbal medications, lotions to oral medications to end excessive sweating. None of those methods have proved to be of any lasting value. The surgical approach to this problem started about 60 years ago but, due to the location of the sympathetic nerve chain in the body, surgical procedures at that time necessitated a very invasive surgery. The operation used to be done either through the neck, chest cavity, or through the back. Those invasive methods made it an unpopular operation for patients and the medical community at large. Since the introduction of minimally invasive surgery in the early 1990s, methods were developed to access the sympathetic nerve chain with minimally invasive surgery (the patient returns home the same day of the procedure).
Improvements are constantly being sought. The most recent improvements are the clamping method versus the cutting method as well as a change in the level of the sympathectomy from the classical T2 location (second rib level) to the 3rd and 4th levels. By making these improvements, we hope to further reduce the amount of compensatory sweating, especially with respect to severe cases.
The future of hyperhidrosis treatment:
Obviously because of the genetic nature of hyperhidrosis the best theoretical solution will be a genetic one. As of right now we are offering a mechanical solution for a physiological problem which has great success rates but is not perfect. When a genetic solution is found then hopefully the treatment of hyperhidrosis will be even better. That being said surgeons, including Dr. Reisfeld, are continually evaluating, researching, and working towards improved solutions.
Another statistical improvement that was noted after the sympathectomy being done at the level T3 to T4 is the improvement with regard to heart rate. Previously when the T2 level was done Dr. Reisfeld used to not recommend this operation for patients who were engaged in heavy athletic activity such as competitive tri athletes etc. What we found was that after performing on level T3 to T4 there was less influence on heart rate reduction and patients were still able to raise their heart rate to around 160 beats per minute. Gustatory sweating which was more common after performing the T2 sympathectomy became quite rare after performing the T3-T4 sympathectomy. Again Dr. Reisfeld believes that a major breakthrough may arrive once genetic manipulation is a common treatment modality.
Dr. Reisfeld has authored several studies on the topic of hyperhidrosis in medical journals, reviewed by other experts in the field, and has been interviewed by several TV programs (CBS, FOX, 48 Hours, Life Moments). In addition, Dr. Reisfeld has contributed material in many publications (Newsweek, Heart & Soul). Dr. Reisfeld has exceedingly improved upon the clamping method by creating an even safer and more effective surgical procedure to treat this ailment. Learn more about Doctor Reisfeld's Hyperhidrosis research.
Hyperhidrosis and Genetics:
With regard to the cause of hyperhidrosis, a definite answer cannot be given. There seems to be a genetic correlation with hyperhidrosis. In Dr. Reisfeld's extensive studies, he found that 50% of his patients have some sort of genetic pattern. Another study showed an even higher percentage of genetic origin to this problem. Dr. Reisfeld, and other researchers around the globe, are constantly making progress in this field of medicine.
In a recent Asian study they were able to locate the exact location on the gene that is responsible for excessive hand sweating. The exact practical value of that finding is yet to be determined and it will be quite a long time before a genetic solution to the problem could be found.
Do you have any questions that were not answered here? Would you like to speak with Dr. Reisfeld to answer those questions? To learn more about what we can do for you, contact The Center for Hyperhidrosis by contacting our office.
Improved Surgical Methods for Hyperhidrosis:
Over the last few years new methods have been developed to treat different types of hyperhidrosis (Excessive Sweating).
Excessive Hand Sweating - For excessive hand sweating (palmar hyperhidrosis) that is not responsive to conservative methods, ETS is the most appropriate solution.
Excessive Foot Sweating For those who suffer from severe excessive foot sweating that did not see any improvement when ETS was performed or suffer from excessive foot sweating as a primary problem then lumbar sympathectomy is new option for their problem. It carries a success rate of 97 - 98%. (Newly offered in the U.S.)
Throughout the average day, our bodies naturally perspire as a way to regulate heat. In some people, natural perspiration is excessive in the face, hands and feet affecting as much as 1-2% of the population. This condition is known medically as hyperhidrosis (sometimes misspelled as hyperhydrosis) which is defined as the production of perspiration beyond what is necessary to cool the body.
The process of sweating is controlled by the sympathetic nervous system. This involuntary nervous system maintains the five million or so sweat glands throughout the body. In fact, about two-thirds of our body's sweat glands are located in the hands alone. The answer to the problem of hyperhidrosis lies within these nerves. Doctors have found that "supercharged" nerves cause excessive sweating. To learn answers to a long list of common questions please visit our Frequently asked hyperhidrosis questions section.