2012年7月3日 星期二

Hyperthermia and Over sweating 多汗症

In Hong Kong, summer temperature is very high and city pollution and over-crowding create an ever increasing stress for out door activites or transit.  Human bodies have adaptive ability to extreme ambient environment.  Working under hight temperature would cause dehydration, heat stroke and cardiac complications.
Over sweating is the consequence of compensation in heat dissipation method in body
Over sweating in the palm and axilla cause embarassment in social life. Usually this begin in young adolescent and has incapacitating effect on social interaction of the youngster.
Both male and female are affected. It appear that male are affected more or they are willing to seek help more. For female, the problem is related more to odor than wetness. Armpit odor is more a problem for them in summer when less covered clothing is trendy then.

Treatment of oversweating or primary hyperhidrosis has long been used in society.

They include

1) self help method
2) Local anti-perspirant
3) removal of sweat gland by local ablation, surgery or injection
4) Botox injection
5) hormonal therapy or drug treatment
6) electophoresis - iontophoresis
7) surgical treatment of sympathectomy

The last method is most effective and durable.

But the drawback must be stated before surgical treatment.

They are:

1) over sweating in body
2) reduce facial flushing or red or lively color of face
3) small chance of failure
4) definite though small risk of sympathetic damage causing dropped eyelids (Horner 's syndrome) and small pupil

For educated patients with well thought of problem, surgery is usually fruitful. Stay in hospital is short and stay for post operative one or two days are common.
wound pain and anaesthetic problem is minimal
Decrease in sweating is permenant.

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