What is Hyperhidrosis?
Did you know? The Japanese are 20 times more likely to suffer from sweaty palms compared to other ethnic groups. Sweating is a normal response to increased body temperature. Sweating more than necessary, and even at rest can be a frustrating experience. Excessive sweating can have a profound effect on one’s social life, occupational performance and psychological well-being.
Hyperhidrosis is the medical term to describe excessive sweating, a condition that affects about 3% of the population. More than half of affected individuals are never diagnosed as they may be unaware of treatment options available. The exact cause of hyperhidrosis is unknown but is suspected to be due to an overactive nerve input that stimulates the sweat (eccrine) glands.
How deep are the axillary sweat glands located?
The eccrine sweat glands cover most part of the body save the ear canals. The coiled stucture of the sweat gland releases perspiration and salt into the external skin to lower the body temperature via evaporation.
A histological analysis of individuals with axillary hyperhidrosis demonstrates that the sweat glands are located on average about 3.5mm in depth from the skin surface.
Treatments that are able to reach this depth with minimal injury to the surrounding skin structures would be preferable.
Hyperhidrosis Disease Severity Scale (HDSS)
How is excessive sweating affecting your life? The hyperhidrosis disease severity scale is a validated tool to select patients for therapy and to assess response to treatment.
A score of 1 to 2 is rated as mild to moderate, while a score of 3 or 4 is considered severe. After treatment, a 1-point and 2-point improvement correlates with a 50% and 80% reduction in sweat production respectively.
Hyperhidrosis Treatment Options
There are various options to treat hyperhidrosis, each with their own merits and drawbacks. They include topical aluminium salts, iontophoresis, botulinum toxin injections, oral medications, lasers, microwave devices, fractional microneedle radiofrequency devices (e.g. Genius) and surgery.
Topical antiperspirant therapies which primarily contain 10% or 20% aluminum chloride may cause skin irritation, stain the skin and have only short-lasting effects. Oral medications (e.g. anticholinergics) are associated with various side effects such as dry mouth, blurred vision, difficulty in passing urine and constipation.
Surgical techniques include skin resection, suction-curettage and surgical sympathectomy. Surgery is usually reserved as a last resort for excessive sweating. It is invasive, associated with multiple complications and is by no means 100% curative. Recurrences of sweating are known to occur following surgery.
Elimination of Sweat Glands with Fractional Microneedle Radiofrequency
Fractional microneedle radiofrequency are novel treatments that are effective, safe and offers long-term results for sufferers with axillary hyperhidrosis.
Fractional micro needling treatment delivers radiofrequency energy to precise depths within the skin.
Micro-coagulation destroys the sweat glands permanently. The sweat (eccrine) glands are found at the junction between the dermis and fat layer of the skin. Using gold insulated needles, we can control with precision the depth of thermal energy to be delivered. The treatment is performed at 3 depths; 2mm, 3mm and 3.5mm, in a fractionated pattern to ensure a wider coverage and faster healing.
This treatment has the added advantage of sparing the top epidermal skin layer, as thermal energy is only delivered to the deeper dermal layers, making it a safer treatment for all skin photo-types.
Studies have shown an improvement in quality of life after treatment with fractional microneedle radiofrequency. The majority of patients report more than 50% reduction in their sweating and an improvement in the hyperhidrosis disease severity scale (HDSS).
Step 1: A starch iodine test is performed to define the areas with the most concentrated sweat glands in your underarms.
Step 2: Numbing cream is applied to maximise your comfort during the procedure. This is cleansed off after 20 mins.
Step 3: The treatment is carried out to destroy the sweat glands. Most individuals experience little or no discomfort as the skin is numbed.
After the procedure, the treated area is dressed with a special material to facilitate healing.
Most individuals need at least 2 treatment sessions at 4 weeks interval to facilitate healing. The sweat glands once destroyed do not regenerate. This leads to longer lasting results.
As with any treatments, the results do vary from person to person. Individuals with more severe forms of underarm hyperhidrosis may need more treatment sessions.
The fractional microneedle radiofrequency treatment for hyperhidrosis is safe for all skin types. Mild after effects of the procedure include temporary discomfort, redness, swelling and itchiness of the skin.
An uncommon phenomenon known as compensatory hyperhidrosis can occur after treatment. This may be due to the body’s way of adjusting to the loss of sweat glands destroyed during the procedure.
In humans, most of the sweat glands are concentrated on the palms, soles, and head, and much less over the body and limbs.
We have about 2 million sweat glands found in the skin. The sweat glands in your underarms account for only 2-3% of the total number of sweat glands.
After removing these sweat glands from your underarm, you will still be able to perspire normally.
Any signs of active infection or inflammation of the skin is contraindicated.
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