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Axillary hyperhidrosis, (also known as armpit sweating) is the medical term used for excessive sweating in the armpit of a person. All human beings have some sort of armpit sweating but for about 1% of the population axillary hyperhidrosis involves extreme, dripping sweat in the armpit area. This type of excessive armpit(axillary) sweating is resistant to all types of deodorants and odor controlling medications. At times the excessive axillary sweating is accompanied by the more known entity of palmar hyperhidrosis or excessive hand sweating. Potential patients should realize that the surgical treatment for excessive armpit sweating should be offered only after conservative treatments have failed. A patient with severe armpit sweating should always try some strong antiperspirants such as Maxim or Drysol before considering surgical treatment.
Excessive armpit sweating usually appears around puberty and can become a socially impairing problem. Patients who are afflicted with excessive severe armpit sweating might have to change their clothing two to three times a day. They may also limit the clothing they wear to certain colors to try and hide the problem. In these severe cases people may also be subject to negative comments and attention from their peers or co workers. Causes of Axillary Hyperhidrosis Diagnosis Treatments The Iontophoresis treatment (Drionic Machine) is another conservative method used to treat excessive cases of axillary sweating. It requires steady use and the results are not always satisfactory. Certain medications can be tried but they have a very limited use. Botox Surgical Treatments In this particular method through very small incisions in the armpit area cannulas (suction tubes) are inserted into the planned suction surfaces and with a criss cross type of movement the underlining layer of the skin is scrapped. This destroys about 90 to 95% of the sweat gland hence reducing the amount of sweating dramatically. Alco though these holes certain scrapping instruments are inserted to help with the suctioning of the sweat glands. The benefit of this method is the small incisions, the easy recovery, and the preservation of the hair bearing area. There are some side effects that can happen such as skin loss, scarring (minimal), all of which can treated easily. The formation of fibrotic bands can also be a problem but generally speaking it is a limited one. The success rate is about 90%. Axillary curettage or superficial liposuction does not eradicate all the apocrine in the axillary gland which is almost impossible to do unless you excise the entire skin from axillary area. As a matter of fact leaving about 5 to 10% of those apocrine glands might prevent over dryness which might be somewhat irritating to a patient. The basic principle is to reduce the overall number of apocrine glands which in turn will reduce the amount of sweating and hopefully the amount of smell in cases of bromhidrosis.
Update April, 2007: As you read below, we would like to emphasize again that Endoscopic Thoracic Sympathectomy (ETS) is not recommended as the surgical solution for severe axillary hyperhidrosis (excessive armpit sweating). Excessive hand sweating/ palmar hyperhidrosis is the only indication at present for which we recommend Endoscopic Thoracic Sympathectomy (ETS). For excessive armpit sweating, as you will read below, suction curettage is the only recommended procedure. Normal sweating is necessary for our body as it helps regulate the temperature of the body as well as excretion of some waste products of our body. Another variety of axillary hyperhidrosis is bromhidrosis. In this case certain bacteria (cornebacteria) that are on the skin convert the sweat to a malodoros (foul smelling) end product. There are two types of glands in the axillary area, eccrine and apocrine glands. The eccrine are responsible for the watery production and the apocrine glands secrete a protein-like substance.
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