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Sweating disorders: treatment
Last reviewed: 23.04.2024
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Treatment of patients with sweating is very difficult. Since sweating disorders are more likely to be secondary, the management tactics of such patients should primarily be directed to primary-care therapy.
Conservative treatment of patients with hyperhidrosis includes general and local measures of influence. General therapy consists in the use of tranquilizers to control emotional disorders, closely associated with hyperhidrotic reactions. Biological feedback, hypnosis and psychotherapy have a beneficial effect on the condition of patients, especially with the essential form of hyperhidrosis. Traditional in the treatment of such patients is the use of anticholinergic drugs (atropine, etc.), which cause such side effects as dry mouth, blurred vision or constipation.
X-ray irradiation of the skin is an outdated method aimed at inducing atrophy of the sweat glands. In addition to the harmful effects of irradiation, its use is associated with the risk of various dermatitis. An essential result can be obtained by alcoholization of the stellate node.
Local treatment consists in the use of binders: an aqueous 5-20% formalin solution, 10% solution of glutaraldehyde, an aqueous or alcoholic solution of aluminum salts (10-25%), potassium permanganate, tannic acid (2-5%), which cause a decrease in sweating due to the coagulation of protein matter in the flow channels. Long-term administration of these agents in sufficient concentration causes a significant reduction in sweating; a side effect of their use are frequent allergic dermatitis. Light water electrophoresis for prolonged and frequent use causes anhydrosis of the desired site.
Patients with an- and hypohydrosis are prescribed oil compresses, fatty creams to reduce skin dryness. In case of a violation of thermal adaptation, it is indicated that they are in a comfortable environment (temperature, humidity).
In case of persistent cases of local hyperhidrosis, resistant to conservative therapy, patients with upper chest postganglionic sympathectomy are indicated. Surgical treatment of palmar hyperhidrosis gives an excellent result, the technique of its implementation is simple.
As an alternative method (in comparison with open surgery), a new method of percutaneous radiofrequency destruction of the II thoracic ganglion was proposed.
Recently, the iontophoresis method has been widely used, which is highly effective and is the main one, especially in patients with essential hyperhidrosis. Procedures are carried out with the help of a specially designed device "DRIONIC", which allows you to carry out procedures even at home.
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