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Treatment options for excessive sweating and body odour!

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“Your energy introduces you before you even speak….” This quote describes your potential to be an outstanding individual and explains your efforts to be outstanding in every walk of life! Being a part of a highly competitive and evolutionary world-space is something we simply cannot opt out of! The world as we know it is not only a living paradox of unending possibilities but also a scalable life-size stadium where we just must perform and perform better!

Personal hygiene and grooming is an integral part of our individuality, and we keep no stone unturned to always look our best! Thanks to super advancements in our medical technology that has helped us to overcome numerous shortfalls that until a decade ago were considered a permanent “disability” and we had no choice but to move on or “adjust” with it! Hairfall, dandruff, skin pigmentation, vitiligo, premature aging, etc to name a few!

Excessive sweating has been around since the origin of mankind! A condition called Hyperhidrosis was mostly a medical term out of medical school textbooks that less than 1% of the human population before the invention of the internet. Every third individual seemed to have it, family, friends, co-workers, a stranger on the bus, or train, etc you name it! We`ve all seen those huge sweat patches in the underarms somewhere!

We all sweat and that’s true, it’s called Hidrosis: the human body`s mechanism for thermoregulation but what happens when some people sweat more? Hyper-hidrosis: Extra
sweating.

The human body possesses two types of Sweat Glands:

1. Apocrine:
Apocrine sweat glands are exocrine glands that are located at the fat-dermal interface. They are the less common sweat glands found mostly in the armpits, groin region and around breast nipples. They do not open directly on the skin but secrete with the plasma membrane and open in the hair follicle. These are the sweat glands that are responsible for “sweat smell” or simply sweat odor!

2. Eccrine
Eccrine Sweat glands are the most common sweat glands found all over the body and open directly on the skin as pores on the surface. Hands, feet, chest, back, face, head, buttocks, legs, etc. Their main purpose is to maintain homeostasis by secreting liters of sweat every day!

Some of us have to struggle with excessive sweating and body odour all our lives. International Hyperhidrosis Society estimates that over 365 million people across the globe suffer from Hyperhidrosis.

Causes:

Hyperhidrosis is categorised as:

1. Primary Hyperhidrosis (Focal/Essential Hyperhidrosis):
This type of hyperhidrosis mainly affects Underarms (armpits), Hands and Feet (Palmo-plantar) and face (Facial). There is no specific known reason as to what causes it. In most cases, this problem is not affected by weather/temperature. Whether it is winter or summer, sweating continues.

2. Secondary Hyperhidrosis (Generalised hyperhidrosis):
This type of Hyperhidrosis affects the larger part of the body or in some cases the whole body. Excessive heating of the body or an underlying medical condition or medication can cause this type of disorder.

Temporary treatment options:

1. Anti-Perspirants (over the counter): Water-based or alcohol-free.

2. Clinical grade antiperspirants: Aluminium Hydrochloride based antiperspirants. Aluminum, when combined with sweat form a gel that blocks your sweat gland. While long-term relief is not expected, it can minimize the feeling of constant wetness under your arms. It is highly recommended to consult your family doctor before starting to use such prescription-grade antiperspirants as they are known to induce side effects in the long run.

3. Anticholinergic therapy:
Anticholinergics are drugs that act by blocking the action of acetylcholine which is a neurotransmitter. Drugs such as glycopyrrolate, benztropine, propantheline, oxybutynin, atropine, methscopolamine, etc are mostly prescribed for conditions such as asthma, diarrhea, motion sickness, and gastrointestinal disorders to name a few. Their mechanism is now being studied widely for their potential to reduce the effect of hyperhidrosis. Topical or oral anticholinergics are now available with a prescription. Recently, USFDA cleared Qbrexza® (topical glycopyrrolate) for the management of hyperhidrosis.

(This form of therapy is also associated with several side effects and is NOT a permanent treatment for hyperhidrosis. Please get in touch with your physician to discuss more.)

4. Botulinum toxin Injections:
Commonly known as Botox®, Botulinum toxin has been used widely in the cosmetic and aesthetic medical industry due to its temporary muscle paralyzing effect which is explored for its “anti-wrinkle” properties. It also has a widespread medical application in the treatment of cervical dystonia, hyperhidrosis, overactive bladder, migraine, lazy eye, etc to name a few.

Administered by a trained medical specialist, Botox is administered via an Intramuscular injection to the affected area in variable volumes.

The effect lasts for about 6-9 months and has to be readministered. About 20-25 percent of people suffering from Hyperhidrosis report very little to no reduction in sweating. It can be administered in the axillae (underarms), palms and feet, forehead and sometimes on the face.

Adverse side effects are also reported. It is highly recommended to choose a physician who has ample experience in handling Botulinum toxins. Though rare, Botox anaphylaxis has been recorded by the FDA.

(This form of therapy is also associated with several side effects and is NOT a permanent treatment for hyperhidrosis. Please get in touch with your physician to discuss more.)

Permanent treatment options:

1. ETS Surgery:
Endoscopic thoracic sympathectomy is a minimally invasive surgery that is used to treat severe hyperhidrosis in the palms, face and feet. (Palmoplantar and Facial hyperhidrosis). ETS is a very precision-based surgery that is carried out mostly by a super-specialist thoracic surgeon only. The surgeon identifies the sympathetic nerves which are responsible for sweating of the limb in question and clips them hence causing an incomplete pathway that stops the sweating completely in the affected limb. The surgery is carried out under general anesthesia and is a quick and out procedure with a fast recovery. This surgery might/might not induce a side effect of compensatory sweating.

Dr. Arun Prasad is a pioneer ETS surgeon and the founder of India`s only Centre for Hyperhidrosis Treatment. Contact: +91 98110 82425

2. miraDry®: Microwave thermolysis:
miraDry® is the latest non-surgical and permanent treatment that was cleared by the USFDA in 2011 for the treatment of axillary hyperhidrosis (Excessive sweating in the underarms/armpits).

miraDry® is a medical device that works by generating microwave energy (non-ionizing radiation) which targets excessive sweat glands in the underarm and destroys them using heat. The state-of-the-art device simultaneously uses cooling to avoid any kind of skin or tissue damage. On average about 82*% of permanent underarm sweat reduction and about 90*% underarm odor reduction is achieved. Many patients have reported having witnessed about 70*% visible hair reduction after the treatment.

Most of the patients achieve desired sweat reduction in the underarms in as little as one treatment session only. It is an out-of-office treatment that takes about one hour for each underarm and is carried out under local anesthesia without the need for any surgery or invasive methods. The treatment is virtually a pain-free experience with the patient returning to his/her work the same or the next day.

Short-term side effects such as underarm swelling and soreness, mild bruising with loss of sensation, usually subside within two weeks without the need for any prescription drugs.

There is little to no downtime and the results start to appear almost immediately post-treatment. The treatment is available in 60+ countries globally and is carried out by a miraDry® certified physician only.

The Skin Temple™ Global Aesthetics is Asia`s exclusive miraDry® clinic in India and is located in New Delhi and Mumbai. (Visit Skintemple.in or call 8908903838). miraDry® is available for the treatment of axillary hyperhidrosis only.

Disclaimer: This article is provided for information only, and must not be considered a substitute for your existing medical treatment and/or physician’s advice. It is always a safe practice to take advice only from a medical professional for any medical/health-related issues.

 



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