Palmar hyperhidrosis is a very common functional local abnormal hyperhidrosis with unknown causes. Because of the particularity of race, young people who grew up in subtropical areas are particularly prone to this problem. The secretion of sweat glands is controlled by sympathetic nerves, and palmar hyperhidrosis is caused by excessive tension of sympathetic nerves for unknown reasons, such as nervousness, excitement, nervousness or abnormal increase of palmar perspiration caused by high temperature in summer. In Taiwan Province Province, the incidence of 10 to 30-year-old youth is about 0.3%, that is, 1 person in about 300 young people suffers from obvious palmar hyperhidrosis, regardless of gender, and their family history is as high as 13% (with family inheritance). Most people have sweaty hands since childhood, and it is more serious in adolescence. All patients with palmar hyperhidrosis are healthy and normal except palmar hyperhidrosis. Most patients also have hyperhidrosis on the soles of feet or armpits, and a few patients also have body odor.
Hyperhidrosis: Common hyperhidrosis includes hand hyperhidrosis, axillary hyperhidrosis, foot hyperhidrosis, and head hyperhidrosis, all of which are diseases caused by excessive excitement of sympathetic nerves and excessive secretion of sweat glands. Sympathetic nerves control sweating all over the body. Under normal circumstances, sympathetic nerves regulate body temperature by controlling sweating and heat dissipation. But the sweating of hyperhidrosis patients is completely out of control. 12% people have genetic susceptibility to this disease. This is a congenital disease.
Second, symptoms
Hyperhidrosis is not a disease, but an overactive sympathetic nerve. However, it often causes troubles in study, work or social interaction because of this symptom, so seek medical treatment. The palms of people who sweat easily are wet most of the time, and long-term wet hands are often easy to peel off, which is even more unsightly. School-age teenagers often get their test papers wet because of excessive sweat on their hands, which often affects the unfinished test papers. Teenagers are afraid to hold hands with others, and even shaking hands is a problem. In severe cases, the palms may even have symptoms of eczema and dermatitis. As adults, it also brings inconvenience to their work and social activities. Hyperhidrosis patients often sweat on their hands and feet, but the sweat of patients usually has no odor, which is different from that of patients with body odor. People with body odor (underarm hyperhidrosis and body odor) are related to their genetic constitution, mainly because the sebaceous glands under the armpit are developed, the probability of occurrence is higher than that of palmar hyperhidrosis, and the troubles caused are more common. For example, clothes always have yellow stains that can't be washed out, so I dare not wear sleeveless tops. Most importantly, when they are close to others, they will have more inexplicable psychological burdens and fears.
Hyperhidrosis and facial flushing are the most common. Hyperhidrosis patients are always sweaty, wet and cold in palms, soles and armpits, and sometimes sweat beads, which is more serious when they are nervous. Often wet the paper when writing, wet the keyboard when typing, and dare not shake hands with others. Patients with "sweating head" and "flushing face" sometimes have sweating head, flushing face and fever when they meet the leaders of strangers and acquaintances, when they are nervous and excited, when they exercise, when they meet the opposite sex and talk about sensitive topics.
Although these diseases are not serious, sweating and/or blushing make patients feel helpless, anxious or panic every day, which brings great inconvenience to their work and social life and seriously affects their self-confidence. The patient's psychological pain is too great for ordinary people to understand. Hyperhidrosis, head sweating and facial flushing's (red-faced phobia) are chronic diseases with little effect.
Third, treatment.
The treatment of palmar hyperhidrosis can be divided into internal medicine and surgery. Drugs used in internal medicine to inhibit sympathetic nervous system often have side effects such as thirst or gastrointestinal dysfunction, which makes people afraid to take them for a long time. However, due to time constraints, frequent application of local drugs is not a very convenient method. Because all medical methods have their limitations, surgical treatment has become the general trend. The sympathetic nerve that controls the sweat glands of the hand is located in the second and third sections of the thoracic spine, that is, on both sides of the dorsal spine, that is, around the nipple line. As long as these two sympathetic nerves are cut off, you can achieve the goal of not sweating your hands. The traditional surgical method is to cut through the center of the back, cut off the bone at the intersection of the ribs and the spine, and cut off the second and third sympathetic ganglia on both sides. Because the operation takes about 2-3 hours, there is a wound about 5-7 cm after operation, which is painful and takes a long time to recover. It takes about 3-5 days to be hospitalized. In addition, it may also cause pneumothorax (air leakage in the lungs makes the lungs unable to breathe, which is a life-threatening sequela), which has been mostly replaced by video endoscopic sympathectomy. This operation has a small wound and does not need suture. The operation process takes less than half an hour. After the recovery of anesthesia, you can go home and rest on the same day, and the success rate of surgery can be as high as 98%.
Thoracoscopic thoracic sympathectomy can treat these diseases only by cutting two small incisions with diameters less than 1 cm on both sides of armpit, and the operation can be completed without thoracotomy. Small incision, small pain, small scar, does not affect the appearance. Generally, they were discharged about 2 days after operation, and most patients' symptoms disappeared immediately after operation. The cure rate is high, and it can quickly return to normal work and life. The pain of patients for several years and decades disappears immediately, and the self-confidence of patients increases rapidly, which will soon disappear in normal social life, interpersonal communication and work. Psychometric research shows that the mental health level of patients after operation has also been significantly improved. The success rate of treatment is as high as 95-99%.
Four. Controversy and sequelae of surgical treatment
Although the surgical treatment of hand sweating is indeed effective, compensatory sweating often occurs after hand sweating stops. Compensatory sweating means that the sweat in the upper body (above the nipple) almost stops after operation, while the lower body is often wet. Except in extremely cold weather, compensatory sweating persists and will not decrease with time, on the contrary, it may be more. This is one of the most unbearable sequelae after the operation.
5. At present, the most effective treatment to keep hands dry is antiperspirant (iontophoresis).
What is iontophoresis (antiperspirant)?
This method is to electrolyze some substances that can be electrolyzed by direct current, and then force particles with positive and negative electrodes into the skin surface. Minerals contained in domestic tap water can also be electrolyzed and successfully used to cure many patients.
Why is electrolysis (sweating machine) effective?
Particles with positive and negative electrodes are in the surface layer of skin: stratum corneum, which reacts chemically with cells and forms a blockage at the mouth of sweat gland, but it does no harm to sweat gland itself and restores the sensitive and anxious nerves to a stable state.
How is the treatment?
In this process, the patient's hands or feet (one part at a time) are shallowly immersed in a plastic box with a sponge at the bottom. After turning on the power supply, the current is brought to the sponge soaked in tap water, and the electrolyte is supplied from the sponge to the affected area. Generally, there is no uncomfortable feeling during the treatment. Each part is treated for about 30 minutes at a time and treated every day. After 6 to 10 hours of treatment, the affected parts will remain dry for up to 6 weeks. When hyperhidrosis occurs again, the whole course of treatment can be repeated. In order to ensure a continuous dry life, call 1-2 times a week after stopping sweating.