Dermatology

Sweat gland treatment – treating excessive sweati

The technical term for excessive sweating is hyperhidrosis. Those affected recognise primary hyperhidrosis through uncontrollable, excessive sweating. The sweating is usually localised to the hands, feet, armpits, face or neck. This is because there are a particularly large number of eccrine sweat glands in these areas of the body. These produce the watery, largely odourless type of sweat.

Sweating is a vital reaction of the body to equalise temperature differences and protect the body from overheating. Once normal body temperature is reached, the sweat glands stop producing sweat. However, people with hyperhidrosis sweat completely uncontrollably, even without sporting activities or extreme heat. The sweat glands of those affected are neither increased nor enlarged, they are merely overstimulated. The cause of excessive sweating is thought to lie in the autonomic nervous system. However, constant sweating is not only unpleasant and annoying. The constantly moist skin is also an ideal breeding ground for eczema, warts or fungal infections.

Doctors differentiate between primary hyperhidrosis and secondary hyperhidrosis, which occurs as a result of an illness. At ETHIANUM Heidelberg, specialist dermatologist Amina Ballout is responsible for treating sweat glands. In addition to a detailed medical history, it can be important for the dermatologist and your treatment plan to define exactly where the areas of sweating are located. For this purpose, Mrs Ballout carries out the Minor sweat test. This test is based on an iodine-starch reaction. An iodine-potassium iodide solution is applied to the affected, well-dried areas. The area is then powdered with cornflour. The hyperhidrosis causes the affected areas of the body to become visible through discolouration. This allows the area to be treated to be precisely localised. The specialist can also use this sweat test to determine the amount of sweat produced. This helps to measure and track the success of the therapy in the long term.

You can find out more about the different therapy options available for the treatment of sweat gland overproduction in this compact guide.

Sweat gland treatments – different therapy options

Your specialist will discuss the choice of treatment for excessive sweating with you after a detailed examination and consultation. This is because there are different treatment options for primary hyperhidrosis. For example, local or internal applications can be considered. Surgical interventions are also possible.

Local applications:

• Aluminium chloride hexahydrate: This substance suppresses perspiration by closing the glandular ducts. It is applied to the affected areas in concentrations of between ten and 30 per cent. If skin irritation occurs, the substance should be applied in higher concentrations.
• Creams, powders or lotions containing tannic acid: Tanning agents denature the proteins in sweat, thereby blocking perspiration. The effect of tanning agents is less than that of aluminium hexahydrate. However, the substance can also be used on inflamed skin or eczema.
• Tap water iontophoresis: In this application, a weak direct or pulsed current is passed through the affected areas. This normalises sweat gland activity. For hands and feet, this application can be carried out in the form of baths. For application to the face, armpits or back, the current is applied to the skin using special sponges. The treatment is painless and has no side effects. It takes about 20 treatments. Each treatment lasts 15 minutes and must be carried out two to three times a week. After the treatment period, sweat production begins to normalise. Unfortunately, this method is not suitable for people with metal implants or pregnant women.
• Neurotoxin B, type A: The injection of the well-known neurotoxin under the skin paralyses the nerves in the defined skin area. The method reduces sweat production very effectively. The effect of the treatment can last up to 18 months and is suitable for the treatment of hyperhidrosis 6 to 12 months.

Internal application (systematic therapy):

• Sage extracts: sage can be taken as a tea. The exact mechanism of action is not known.
• Antihidrotics: Substances such as methanthelinium bromide are similar to the body’s own messenger substance acetylcholine in our nervous system. They inhibit the impulse that the nerve sends to the sweat glands, which over-excites them. Unpleasant side effects can include dryness in the mouth and other mucous membranes.

Surgical procedure:

• Subcutaneous suction curettage: A thin cannula is inserted under the skin through tiny incisions in the previously defined area. The subcutaneous fatty tissue is suctioned out. The sweat glands are also scraped off.
• Laser lipolysis: The millimetre-thin laser fibre is guided under the skin in direct contact with the fat cells in the armpit. The laser beam dissolves the fat cells. They can then be gently suctioned out. The laser energy breaks up and degenerates the sweat glands. Laser lipolysis and subcutaneous suction curettage are also used in combination. Both procedures can be carried out under local anaesthetic.

OUR DOCTORS

THE SPECIALIST FOR DERMATOLOGY AND AESTHETIC MEDICINE

Amira Ballout is the head dermatologist at the ETHIANUM. Get to know the dedicated and friendly specialist better.

Amira Ballout is a specialist in dermatology and venereology. She has acquired special expertise in the field of aesthetic medicine and treatments with biologic therapies for chronic inflammatory skin diseases. As a specialist in the field of aesthetic and classic dermatology, Ballout knows how to treat her patients in the best possible way

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