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Why a sympathectomy for sweaty armpits may not be the best idea

Why a sympathectomy for sweaty armpits may not be the best idea
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A rarer form of hyperhidrosis – excess sweating – is compensatory hyperhidrosis, caused by strange nerve signals due to sympathectomies, and not the usual suspects of heat, fear or anger.

People who get ‘compensatory hyperhidrosis’ after sympathectomies are part of a group of people with specific health conditions affecting nerves, or for example after an accident or surgery. We’re not really sure why this odd type of sweating happens, but it’s believed that part of the brain that regulates our body temperature kicks into gear by mistake. The point of the sweating is to reduce body heat, but body heat may not be too high at the time.

 If you get sweaty armpits, feet or hands when you get angry or feel afraid, this is called focal hyperhidrosis (regular excess sweating, in certain areas), and is manageable using radiofrequency or neuromodulating injections, or just grinning and bearing it if it’s not too bad. Compensatory hyperhidrosis, however, is more difficult to treat, since it involves something that has already occurred to a nerve, like by mistake after surgery to treat focal hyperhidrosis.

Regular hyperhidrosis is an excessive sweating condition limited to certain body areas, and has no known cause. This type of regular hyperhidrosis appears as sweaty armpits, palms, soles, groin, face and scalp, with both sides of the body affected the same amount. This type of sweating doesn’t happen at night or while sleeping typically, and usually you will appear as ‘a sweater’ before you hit age 25. Sweaty armpits are the most common place to sweat excessively, followed by feet, hands, and the face.

Once you get older, generalised sweating tends to take over as the predominant sort of sweating.

Compensatory hyperhidrosis can be at best pretty annoying, at worst a damaging interference in your life, since a person may have to change their outfit many times a day to remove sweat-soaked clothes. In certain types of surgery like the sympathectomy, permanent damage is deliberately done to nerves, but this type of sweating can be the unintended outcome.

Sympathectomy surgery involves severing the nerves that supply the sweat glands of the armpits, to treat sweaty armpits, but cause the body to produce excess sweat in other areas of the body like the trunk and lower back. It is not really compensatory at all; it’s just gone wrong.

It’s important to note there that our Melbourne-based sweaty armpit treatments do not sever any nerves! They are locally acting on the sweat glands in the armpits only and are safe and effective.

After a sympathectomy, the top part of the body may stop being able to sweat at all, complicating things. This can lead to overheating. Only some people who undergo a sympathectomy will end up with more sweating in other areas, and there doesn’t seem to be any links to age, weight or gender, and no screening test for predicting.

Another nerve-based form of sweating that can be kicked off by sympathectomies is gustatory sweating or Frey’s syndrome – gustatory sweating occurs while eating, thinking or talking about food that triggers off your salivary gland response.

Nobody is quite sure why this happens, but a connection has been made between the sweat glands and salivary glands after nerves have regenerated. Other symptoms may be goosebumps, flushing, body temperature drops, and more.

Sweating of the face can also occur after a sympathectomy, whereby during salivation, the face starts to sweat. This is also known to occur in diabetes, some headaches, and some nerve injuries. Phantom sweating may also occur: you think you are sweating, but aren’t.

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