University of Maryland Rounds features clinical and research updates from the University of Maryland School of Medicine and the University of Maryland Medical Center.

Intended for physicians, Rounds contains contact information to learn more about the clinical and research advances featured in each issue. It is printed three times a year and distributed monthly via email.

A police officer who could not appropriately grip his weapon. A soldier too embarrassed to shake hands with superiors. A teenager whose golf club flew out of his hands at a driving range. A woman whose hands slipped off her steering wheel while driving.

All these people came to University of Maryland Medical Center (UMMC) with a chief complaint: Hands so sweaty that their quality of life — or indeed their safety — was impacted. The diagnosis was Hyperhidrosis, a condition causing excessive and unpredictable sweating, even when temperatures are cool and those affected are at rest.

Loosely translated as "excessive water," Hyperhidrosis is believed to affect up to 3% of Americans, though the exact underlying cause remains unknown. At UMMC, this translates into a range of about 12 to 40 people each year who come here seeking help for treatment.

Normal Perspiration Goes Awry

The body typically triggers sweating as an involuntary response to stress, overheating, or anxiety. But in those with hyperhidrosis, this normal sweat response goes haywire, typically affecting the palms, soles of the feet and armpits. In other cases, the face, groin, belly or small of the back becomes the site of profuse and unstoppable perspiration.

Sweating can be linked to medical conditions, including thyroid problems, heart disease, menopause or cancer. However for patients with hyperhidrosis, this is typically their only medical issue.

Wide Variety of Treatments Includes Surgery

Treatments for hyperhidrosis span between a wide range of products, medications and procedures. They include:

  • Prescription-strength antiperspirants containing 10% to 20% aluminum chloride hexahydrate, which can block sweat glands under the arms
  • Medications, such as glycopyrrolate (brand name Robinul), which decrease secretions throughout the body, including from the sweat glands
  • Iontophoresis, a procedure using electric pulses to temporarily deactivate sweat glands in hands or feet
  • Botox, or botulinum toxin, injected to block the nerves stimulating sweating, typically under the arms
  • Endoscopic thoracic sympathectomy (ETS), a surgical technique that interrupts the Sympathetic Nerve chain at specific levels that are producing increased sweat-provoking signals.

Special training is required to perform ETS surgery, which is an elective procedure. Side effects include so-called compensatory sweating, meaning patients develop excessive sweating in a body region previously unaffected. Life-threatening complications, while rare, can also result.

When successful, which is typically the case, hyperhidrosis surgery "revolutionizes" patients' lives.

Appointments can be made by calling 410-328-6366.

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