Hyperhidrosis treatment Malaysia
What is hyperhidrosis?
Under normal circumstances, our bodies sweat to help maintain stable body temperature. Sweat absorbs the heat from our bodies, and evaporates to reduce our body temperatures. In the absence of sweating, our bodies could overheat.
However, if a certain area of your body, or your whole body sweats much more than is actually required to maintain normal body temperature, it may be a sign you have hyperhidrosis.
Who can be affected by hyperhidrosis?
Around 3% of the South East Asian population suffer from hyperhidrosis. It is a fairly common condition that begins as early as adolescence and persists throughout most of adulthood. Certain aggravating factors include anxiety and stress.
Although not life threatening, hyperhidrosis may have a profound impact on quality of life. Patients who suffer from the condition may have difficulty grasping objects. Some occupations may prove challenging for these patients, as they may be required to have a good grip on the equipment they are handling e.g. drivers, chefs handling knives, typists.
Hyperhidrosis patients may intentionally avoid social situations that require physical contact such as hand shakes, due to the potentially awkward and embarrassing ensuing scenario. Hyperhidrosis may also contribute to foul smelling body odour, causing the patient to further suffer from low self-esteem.
What causes hyperhidrosis?
A person with hyperhidrosis could either have the primary or secondary form of the condition.
Primary hyperhidrosis is idiopathic, meaning that doctors and scientists have not been able to find the underlying reason apart from just having overactive sweat glands. Some research suggests that it is genetically related, although no particular gene has been identified.
In secondary hyperhidrosis, the excessive sweating can be associated with other medical conditions that the person is suffering from for example obesity, diabetes mellitus, menopause, malignancy and endocrine abnormalities such as hyperthyroidism.
What is the treatment for hyperhidrosis?
Although there is no straightforward explanation for hyperhidrosis, we do have various treatment options to relieve excessive sweating.
The most common topical treatment is also the least expensive. There are plenty of well known over the counter anti-perspirants available at your local pharmacy.
These antiperspirants do not require a prescription, and works by blocking the pores so the sweat is unable to escape. The common active ingredient is aluminium chloride.
This ‘medication’ is applied onto clean and dry skin overnight and washed off the next morning. The recommended usage is daily application initially for the first week, then once weekly afterwards for maintenance. The main side effect is skin irritation, which can be overcome by reducing frequency of application.
Iontophoresis uses low intensity currents to disrupt the function of the sweat glands. This treatment is immensely time consuming, requiring twice weekly treatments for up to 6 months. Considering the tremendous amount of commitment and discipline required, patient compliance is a huge factor that hinders most patients from achieving successful treatment outcomes.
If a person has generalised hyperhidrosis, then likewise a systemic treatment affecting the whole body would definitely be more efficacious. The preglandular neurotransmitter for sweat is acetylcholine.
Anticholinergics are drugs that inhibit acetylcholine binding to their receptors thus reducing sweat production. A study in 2012 showed that 75% of patients taking the medications reported reduced sweating.
Due to a long list of unwanted adverse effects including dry mouth, blurring of vision, constipation, difficulty passing urine, dizziness, palpitations and insomnia, systemic therapy is tends to be less favoured both by patients as well as physicians.
Neurotoxin was approved in 2004 for treatment of excessive sweating. Neurotoxin temporary treats the condition by blocking the sweat gland activity. The procedure is able to reduce sweating by up to 87%, and can last anywhere between 4-12 months.
Unwanted side effects include temporary muscle weakness, especially in the hands.
Endoscopic Thoracic Sympathectomy surgery
Sympathectomy, also known as nerve surgery involves cutting, clamping or burning the nerves that cause the excessive sweating to occur. This procedure is mainly reserved for resistant cases that are not responsive to other treatments. The success rate with surgery is 98% for palmar hyperhydrosis and 85% for axillary hyperhidrosis.
The most common side effect is compensatory sweating, where there is exaggerated sweating from lower chest, back, abdomen, thighs and legs.
In a pilot study published in the European Journal of Plastic Surgery in 2019, a permanent decrease in sweating over 50% was achieved in 80% of patients treated with Lutronic Genius. This study suggests Lutronic Genius to be a novel, safe, effective, permanent and minimally invasive treatment for hyperhidrosis.
The mechanism of reduced hyperhidrosis by way of the RF device is that the sweat glands are destroyed by heating the interface where they are located, that is the hypodermic interface. The radio frequency from the tips of the needles causes direct thermal injury which decreases the size and density of the apocrine glands.
The results demonstrate that Lutronic Genius is well suited for targeting sweat glands while offering protection for both the upper skin layers and the structured beneath the subcutaneous fat.
Immediately after treatment, minimal undesirable effects such as mild skin irritation, erythema and pin point bleeding may occur.