Sweat Gland Removal - Introduction
Sweating normally represents a physiological mechanism for the regulation of body temperature. Through the separation of sweat, body temperature is guaranteed to remain within certain limits even during physical exertion or when external temperatures are higher. The activity of the sweat glands can exceed normal limits, however. One such condition, in which one sweats excessively when one is not physically exerting oneself, under stress, submitted to increased external temperatures, or other similar triggers, is called hyperhidrosis (using latin medical terminology). Those affected suffer from visible sweat drops under the arms that often extend to the hips or from sweaty hands or feet. All these effects can restrict one's daily life considerably. If conservative measures cannot bring the desired results, the offending sweat glands can be removed in an operative procedure. Alternatively, the nervous supply can be cut off, which in turn inhibits the activity of the sweat glands.1
Conservative measures include, among other things, certain medications which inhibit nervous transmissions to the sweat glands and thus their activity. The injection of botulinumtoxin A ("botox") can also achieve a temporary reduction in sweat secretion.
The most gentle operative procedure is called sweat gland suction curettage. In this procedure, which is outpatient and uses local anaesthesia, the sweat glands are simply cleared out using suction - similar to liposuction. The sweat glands are then abraded and their nervous supply is severed. The advantage of this low-complication method lies in rapid return to daily life and barely any remaining scars. The rate of recurrence is, however, relatively high. In a sweat gland excision, which is being performed increasingly less often, skin flaps along with the sweat glands are surgically removed and the wounds are subsequently sewn shut.
In this case, the wound healing process lasts somewhat longer and larger visible scars are left behind. In serious cases, operative treatment of the sympathetic (vegetative) nervous system, which is responsible for the activity of the sweat glands, can be treated. For this larger procedure, the sympathetic nerves are severed using cuts on the sides of the ribcage, then either removed or clamped. In the first weeks after the procedure, you should be gentle with yourself and handle the treated region with utmost care.
The wounds need to be checked by a doctor on a regular basis. The length and scope of aftertreatment depends on the scope of the procedure and should be discussed individually with your doctor. In the time prior to the above-named procedures as well as in the time following them, you should forego the consumption of alcohol and nicotine and should discontinue taking anticoagulant medications. The risks in sweat gland suction are very low; in rare cases, wound infections can occur. In an excision or especially in a sympathetic nerve treatment procedure, bleeding, infections, wound healing irregularities, or unwanted nerve damage and secondary complications can occur.