Sweat Gland Removal - Methods

The secretion of sweat is based on the activity of the sympathetic nervous system, a part of the vegetative nervous system, which runs to the right and the left of the spinal column in what is called the sympathetic chain. The sweat glands thus have the primary tasks of keeping the body temperature within constant limits through the secretion of sweat.

However, the abnormally heightened production of sweat can lead to severe impairments in daily life. Large sweat patches in the armpits, the accumulation of salty deposits in the clothes, or a moist handshake can be felt to be disturbing and thus impose limits on the daily life of the person affected. Depending on the cause, two subtypes of hyperhidrosis can be distinguished. In primary hyperhidrosis, the cause is not known. In secondary hyperhidrosis, the cause is another pre-existing illness. This can be, for example, an endocrine disease (i.e. hormonally conditioned, e.g. diabetes mellitus, hyperthyroidism, etc.), a psychological or neurological disease (injured sympathetic nervous system), or can be traced back to particular medications. Excess sweat production occurs in the area of the armpits (hyperhidrosis axillaris), in the hands and feet (hyperhidrosis manuum et pedum) or in the area of the head (hyperhidrosis facialis) in most cases.

For the treatment of hyperhidrosis, there are many possibilities. For secondary hyperhidrosis, the first priority is to identify the root illness and treat it appropriately. For primary hyperhidrosis, there is the possibility of conservative therapy through localised methods (application of sea salt or similar alternatives) or taking certain medications. Another possibility is the medicinal blocking of sympathetic nervous transmissions in order to inhibit sweat secretion. ^1,2

This is possible with the nervous toxin botulinumtoxin A (among others) which, when in injected under the axillary skin stops sweat formation for about 4-10 months. ³

It is only when conservative substances do not offer satisfactory results that one can fall back on operative methods. ^1,2

For the operative methods, two fundamental distinctions can be made: the first is sweat gland suction (subcutaneous sweat gland suction curettage) in conjunction with abrasion (subcutaneous sweat gland curettage) and the second is the surgical removal of the sweat glands by cutting them out (sweat gland excision). For the suction of offending sweat glands, local anaesthesia is used and 1-2 small incisions are made through which the sweat glands are then subjected to suction and abrasion. This method is relatively low-risk, but after 1-2 years there may be a renewed occurrence of hyperhidrosis. An excision operation represents a somewhat larger-scale procedure which is carried out increasingly less often due to the large surface area of the wound. For this procedure, likewise performed using local anaesthesia, the affected skin regions including the sweat glands are completely cut out and the incisions are then sewn shut.

In very serious cases, general anaesthesia may be used in the execution of what is called a sympathectomy or sympathetic blockade. During the operation, the parts of the sympathetic nervous system which deal with the sweat glands are either severed, cauterised, or clamped using a metal clip. Preconditions for this operation are that you should be in good general health and be between the ages of 18 and 40. A side effect of this treatment, however, is compensatory sweating in other regions of the body. This means that the loss of sweat separation in one place is compensated for by increased sweating in other places. ^4,7

Please speak about the above-mentioned methods as well as further possible methods in detail with the doctor who is treating you.