iOS app Android app More

Featuring fresh takes and real-time analysis from HuffPost's signature lineup of contributors
Dr. Rock Positano

GET UPDATES FROM Dr. Rock Positano
 

Excessively Sweaty Hands: A Slippery Slope When It Comes To Social Functioning

Posted: 06/20/08 01:11 PM ET

It's only natural to have clammy hands when nervous or excited, but imagine having excessively wet, sweaty hands all the time......hands that literally drip with sweat, making the simple act of shaking hands embarrassing and uncomfortable. An estimated 3 million Americans experience excessive sweating - a medical condition called hyperhidrosis - that causes perspiration far greater than the physiological needs of the body. Excessive hand sweating (palmar hyperhidrosis), can be severe, affecting a patient's everyday life both socially and functionally. Fortunately, a minimally invasive surgical procedure called Bilateral Thoracoscopic Sympathectomy (BTS) is available to permanently treat the condition.

Regulated by the sympathetic nervous system, which controls about 5 million sweat glands, perspiration is the body's natural means of cooling down during exercise, heat or anxiety situations. Although doctors don't know the exact cause of hyperhidrosis, there seems to be a genetic correlation and it has been successfully linked to over-activity in the sympathetic nervous system. The condition is characterized by excessive sweating that can happen in even the most relaxed setting, is profuse, noticeable, uncontrollable and unanticipated.

"Excessive sweating of the hands may not seem like a serious enough problem to warrant surgery, but people who suffer from it deal with everything from minor issues such as smudged paper to major ones such as difficulty holding pens, tools, buttons and social isolation," says David Sekons, MD, attending surgeon at Beth Israel Medical Center who has performed more than 400 BTS procedures. "Years ago, treating the condition surgically involved opening up the neck, back or chest cavity - but now we have a procedure that is safe, effective and minimally invasive. I have received hundreds of cards from patients who gush about how the surgery has literally 'changed their lives.'"

About the BTS Procedure:

Bilateral Thoracoscopic Symathectomy is performed under general anesthesia and takes about one hour from start to finish. Because the sympathetic branch of the nervous system is located within the chest cavity, the first step is to collapse the lung to make room for the surgeon to operate. Next, a fiber-optic camera (thoracoscope) is inserted through a 1cm incision made below the armpit so the sympathetic nerve chain can be located at the back of the chest. The surgeon then divides the nerve chain at the appropriate level in order to interrupt the nerve signal transmission from the sympathetic nerve to the sweat glands. After re-inflating the lung, the surgeon performs the exact same procedure in the opposite chest. The patient stays in the hospital for a few hours and is discharged the same day.

As with any surgery, there are risks of bleeding and infection. Therefore, conservative, non-surgical treatment is often suggested and recommended before considering a surgical intervention. Non surgical options include: aluminum chloride, a topical solution that is very similar to the active chemical in an antiperspirant and is applied directly to the hands; iontophoresis, an electrical current that is applied to a solution into which the hands are placed; botulinum A neurotoxin, the toxin is injected into the palms of the hands every 7 to 12 months; anticholinergic drugs, a prescription drug that may decrease or stop sweating.

"Although surgery can be performed at any age, the late teenage years are an ideal time for surgery because there is less risk of compensatory sweating," says Dr. Sekons. "Compensatory sweating is sweating that occurs on other parts of the body such as the thighs, back, abdomen and face following surgery. It is usually mild to moderate, is well tolerated and has a tendency to decrease within the first 6 to 12 months following surgery." And for most people who have had a hard time just shaking hands with someone for as long as they can remember, a little sweating in less noticeable areas is a small price to pay for the freedom from daily embarrassment.

For more information about Dr. Sekons and his treatment of hyperhidrosis, please visit www.sweatypalms.org.