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Neurology (Expert Forum)
Hypderhidrosis of hands and feet
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Hypderhidrosis of hands and feet
by princesserica, Jul 22, 2006 12:00AM
Is any good medication for treating hyperhidrosis of the hands and feet? I'm not a big fan of using drysol or other topical agents. Centrally acting agents, such as Zanaflex helped but the side effects are not tolerable during the work day.
Do you see any value in using alpha 2 blockers to treat this condition, if they become available? Based on my limited understanding of the SNS, it appears alpha 2 might be worth a try. Just reaching for straws here.
Since my condition isn't too bad, I don't think surgrey is worth considering.
One other question, I have no family history of hyperhidrosis and I have had all the tests to rule out other medical conditions that might cause this condition? Thyroid tests and 24hr VMA, etc. Other than pointing to anxiety, do you know of other test that might be useful in trying to find a cause. Is it possible that I have a autonomic dysfunction. This is not a condition that I have had all my life. It suddenly started one day about 2 years ago. In all the cases I have read, I have not seen a single case where someone developed this condition when they were in there 20s or 30s years old, with the exception of secondary causes. I developed it when I was 31, I'm now 33 and in otherwise good health.
I realize that I'm probably not going to find a cause or a good treatment option, but I figured it was worth a try. Also my condition is mild so if I don't, than no big deal. I can live with it.
Thank You
Do you see any value in using alpha 2 blockers to treat this condition, if they become available? Based on my limited understanding of the SNS, it appears alpha 2 might be worth a try. Just reaching for straws here.
Since my condition isn't too bad, I don't think surgrey is worth considering.
One other question, I have no family history of hyperhidrosis and I have had all the tests to rule out other medical conditions that might cause this condition? Thyroid tests and 24hr VMA, etc. Other than pointing to anxiety, do you know of other test that might be useful in trying to find a cause. Is it possible that I have a autonomic dysfunction. This is not a condition that I have had all my life. It suddenly started one day about 2 years ago. In all the cases I have read, I have not seen a single case where someone developed this condition when they were in there 20s or 30s years old, with the exception of secondary causes. I developed it when I was 31, I'm now 33 and in otherwise good health.
I realize that I'm probably not going to find a cause or a good treatment option, but I figured it was worth a try. Also my condition is mild so if I don't, than no big deal. I can live with it.
Thank You
Doctor's Answer
by CCF-Neuro-M.D.-SH, Jul 23, 2006 12:00AM
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes. Hyperhidrosis (excessive sweating) is most commonly idiopathic (unknown cause) and occasionaly secondary. Everyone should have a workup for secondary causes, that include hyperthyroidism, other endocrine causes, obesity, menopause, and anxiety/psychiatric). Idiopahtic cases often develop in childhood/adolescence, but can occur later as well. Treatment includes anti-perspirants, drugs (generally anti-cholenergic, but other as mentioned in your post (all of which have side effects, including the alpha-2 blockers (mostly sedation)), Iontophoresis, Botulinum Toxin (BoTox) injections, and surgery.
Iontophoresis involves adminstering an electric current to the affected area to decrease the activity. Intially it requires 20 minute sessions several times a week, but hen extend to once every 1-2 weeks.
BoTox injections stop the realease of neurotransmiter that causes the sweating and has been shown to work well in the arm pitt and some cases palms/feet. The effect lasts for 6-12 months depending on the dose, and has very little side effects. It does require repeat injections when the effect wears off, and treatments are expensive.
Surgery is generally the last resort for refractory cases. It usually involves a sympathectomy (removal of sympathetic nervous sytem fibers that go to sweat glands) and/or removal of sweat glands in the arm pitt. The sympathectomy can be done relatively non-invase (endoscopic) for the face and hands, but the feet require and open-abdomen lumbar sympathectomy.
I would also recommend that you see a psychiatrist to address whether you have a problem with anxiety that can be treated. I hope this has been helpful.
Iontophoresis involves adminstering an electric current to the affected area to decrease the activity. Intially it requires 20 minute sessions several times a week, but hen extend to once every 1-2 weeks.
BoTox injections stop the realease of neurotransmiter that causes the sweating and has been shown to work well in the arm pitt and some cases palms/feet. The effect lasts for 6-12 months depending on the dose, and has very little side effects. It does require repeat injections when the effect wears off, and treatments are expensive.
Surgery is generally the last resort for refractory cases. It usually involves a sympathectomy (removal of sympathetic nervous sytem fibers that go to sweat glands) and/or removal of sweat glands in the arm pitt. The sympathectomy can be done relatively non-invase (endoscopic) for the face and hands, but the feet require and open-abdomen lumbar sympathectomy.
I would also recommend that you see a psychiatrist to address whether you have a problem with anxiety that can be treated. I hope this has been helpful.
