The process of sweating is controlled by the Sympathetic Nervous System. This involuntary nervous system maintains the five million or so sweat glands throughout the body. In fact, about two-thirds of our body’s sweat glands are located in the hands alone. The answer to the problem of hyperhidrosis lies within these nerves. Doctors have found that “supercharged” nerves cause excessive sweating.
Over the past years, several different approaches have been taken to cure this socially and functionally embarrassing problem. Patients have tried herbal medications, lotions, and oral medications to end excessive sweating. None of those methods have proved to be of any lasting value. The surgical approach to this problem started about 60 years ago but, due to the location of the sympathetic nerve chain in the body, surgical procedures at that time necessitated a very invasive surgery. The operation used to be done either through the neck, chest cavity or through the back. Those invasive methods made it an unpopular operation for patients and the medical community at large. Since the introduction of minimally invasive surgery about 20 years ago, methods were developed to access the sympathetic nerve chain with minimally invasive surgery.
While doctors don’t know why excessive sweating starts, the most likely cause is a genetic one. They have successfully linked it to over-activity in the sympathetic nervous system. Specifically, it is the Thoracic Sympathetic Ganglion Chain, which runs along the vertebra of the spine inside the chest cavity.
This chain controls the glands responsible for perspiration throughout the entire body. These sweat glands are mainly concentrated in the palms of the hands and soles of the feet. In most cases, the hands and feet are affected. To a lesser degree, the face and armpit regions are affected. Another manifestation of the hyperactive sympathetic activity is facial blushing.
It used to be a common thought that excessive hand sweating is caused by overactivity of the thyroid gland but over the years it was proven not to be the case. Another thought was that patients who suffered from anxiety problems would have excessive hand sweating. This was also proven to be wrong as patients can have severe palmar Hyperhidrosis (hand sweating) even in the most relaxing moments of their life.
Simple self-help measures you can take include:
Botox is recommended for the treatment of hyperhidrosis. When small doses are injected into the skin, Botox blocks the actions of the nerves that supply the eccrine glands: this prevents the glands from producing sweat. The effects of treatment can last for several months but will eventually wear off.
Every client will have iodine and starch powder applied to the underarm area in order to delineate the areas of maximal sweat production. Using a very fine needle, you will be injected with a small amount of solution into 10 to 15 places about 1 cm apart and spread evenly in each armpit. A course of treatment takes about 20 minutes.
The effects of treatment will become apparent over the first week. Clients tend to return for their next treatment on average every 6-8 months. The effects of Botox will wear off over a period of several months. If you decide not to have more treatment there will be no lasting change in the areas treated and sweating will gradually return to the level it was before you started treatment.
miraDry is a new and innovative solution to hyperhidrosis. This treatment significantly reduces sweating in the armpits on a long term basis after only two treatments. There is no need to worry that this might be unhealthy as the rest of your body sweats more than enough to make up for any reduction in your armpits. miraDry uses electromagnetic energy to target and destroys the sweat glands. This is long-lasting because the sweat glands don’t grow back. The procedure is painless as the armpits are completely numbed beforehand. The treatment takes approximately half an hour. The effects are immediate, with reduced sweating noticeable the next day. It may seem that some sweating returns a few weeks later, but this is simply the leftover sweat glands and why two treatments are necessary.
There is some swelling afterward, especially the night of and the next day, so icing the areas as much as possible is recommended. The treated areas will also be sore but are easily alleviated with some ibuprofen. However, neither the swelling nor the soreness is the degree that a patient cannot return to work the next day. Some swelling and discomfort might persist for one to two weeks. The armpits will also feel bumpy to the touch, possibly for up to one month. This is a natural part of the healing process.
Dr. Rokhsar is the first miraDry provider in New York with the greatest experience in the tri-state area.
Upper East Side Manhattan
121 East 60th Street, Suite 8AB New York, NY 10022
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901 Stewart Ave, Suite 240, Garden City, NY 11530