Hyperhidrosis natural cure
Hyperhidrosis of Palmoplantar is a common condition in which the eccrine (the sweat) glands of the palms and soles secrete hyperhidrosis surgery the in an improper way large quantities of the sweat. The condition can come be weakening professionally and socially. Hyperhidrosis of palmoplantar hyperhidrosis natural cure of Idiopathic begins in the childhood and runs frequently in families. (1)
The glands of Eccrine are distributed on almost all the surface of body but they are very dense in the palms and soles. These glands are morphologically and functional normal in patients with hyperhidrosis of palmoplantar. (2.3) Because the hyperhidrosis is stimulated for the emotion and the emphasis, does not occur during the dream neither the sedation. Oppositely, to sweat normal is controlled mainly by thermoregulation and, thus, occurs independently of level of the knowledge. The primary defect in patients with hyperhidrosis can be the ultrasensibilidad of hypothalamic to emotional stimuli of the cerebral cortex. (2.3)
The clinical diagnosis of hyperhidrosis of palmoplantar is obvious because the to sweat of the excess can be observed easily. Several options of the processing are available. Some work interrupting the innervation of glands sudaríparas by nice nerves with acetylcholine as the neurotransmitter, but all they have the limitations or the associated complications. Thus, the processing of hyperhidrosis of palmoplantar remains a challenge, and a logical focus they should be taken to individualize the therapy based on the degree of functional deterioration.
The processing more trite cash for the hyperhidrosis of palmoplantar is hexahydrate of chloride of aluminum of 20 percent in the alcohol anhidro absolute of ethyl (Drysol). (3) the results Less satisfactory have been achieved with other agents trite, inclusive boric acid, the drugs of hyperhidrosis surgery anticholinergic, resorcinol, the acid one tánico (2 to solutions of 5 percent), permanganate of potassium, the formaldehyde, methenamine, and glutaraldehyde.
The chloride of the aluminum is thought to block pores of sweat and to induce the atrophy of secretory cells inside the glands sudaríparas. The only counter-indication to this processing is documented the ultrasensibilidad, and chloride of aluminum should not be utilized in the broken neither recently shaved skin irritated.
The patients should apply the agent to dry skin the relief nocha until clinical be achieved, in which indicates the therapy of the conservation is instituted and the frequency of applications can be widespread was hyperhidrosis natural cure with the time in some patients. The morning after a processing at night, the patients should remove residual chloride of aluminum and to apply trite baking soda to limit cutaneous irritation.
The trite therapy has some objections. The conformity can come be a matter because the necessary daily applications for the efficacy can be you considered too much time-consume for patients. (3.4) the Trite therapy can fail also to control adequate hyperhidrosis.
In the past, the drugs sistémicas of anticholinergic have been somewhat successful in the processing of hyperhidrosis of palmoplantar, based on the action of acetylcholine as the neurotransmitter of periglandular inside the innervation nice of glands sudaríparas. In spite of its potential, the drugs sistémicas of anticholinergic are the practical little processing for this condition. The long-term therapy is required, and the drugs have numerous effects of the side, inclusive dry mouth, drought eyes, the constipation, the indistinct vision, mydriasis, and the difficulty with the urination. (5)
Benzodiazepines can reduce the levels of the anxiety, with which diminishing the emotional stimuli that cause hyperhidrosis surgery. Nevertheless, these agents generally are not utilized because they can cause the dependence and the side carries out just as the lethargy and drowsiness. (6)
Iontophoresis, the passage of a direct electric current in the skin, is a therapy long-established for the hyperhidrosis. (7) since its introduction in 1952, iontophoresis has turned out an effective sure processing and relatively economic that is convenient for patients to utilize at home. (8-10) the effects of the Side are generally secondary and related to the individual sensitivity, to higher amperage, and to the time limit of time that a patient utilizes repeated times the processing. The cutaneous irritation can occur, at times with erythema, with the formation of vesícula, with the light pain, or with paresthesia in the treated areas; besides, the secondary burns can occur in the previously injured skin. (11)
The fundamental mechanism of iontophoresis is not understood completely. (12) according to a hypothesis, iontophoresis can induce hyperkeratosis of the pores of the sweat and to block the flow of the sweat and the hyperhidrosis natural cure (although no to cover of the pores have been found). (12) Other mechanisms proposed include deterioration of the electrochemical slope of secreción of sweat and a mechanism of biofeedback.
Various agents have been utilized in conjunction with iontophoresis, inclusive running water, the salt water, and the drugs of anticholinergic. (13) Iontophoresis with salino is less effective than water iontophoresis current. A galvanic current of 0,2 miliamperios (mA) by [cm.sup.2] in the intact skin has not adverse effects of the side, and an upper rate to 20 to 25 mA by surface is generally tolerable. (14)
The successful induction of hypohidrosis by water iontophoresis current requires the application from 15 to 20 mA to each palm or the sole for 30 minutes by session for 10 consecutive days, followed by some sessions of the conservation to the week. Initially, many patients experience an aggravation of their symptoms, but of these resolutions of the problem after three to five processing. Without the therapy of the conservation, the symptoms occur again in one to two weeks. (11) not effects of the side have been reported of the use of hyperhidrosis surgery iontophoresis of 20 mA in women neither patients embarrassed with pacemaker.
The use of the atropina of the drug of anticholinergic during water iontophoresis current is at times the useful care but extreme is necessary to avoid the toxicity of the sobredosis of atropina. Not more than 1 mg of atropina should be added to 30 ML of hyperhidrosis natural cure running water. The solution is verteda on thin gauze placed in a dish inoxidable of anodal of steel. The atropina -- water iontophoresis current should be utilized only by doctors coached well in this method.
The aluminum combined chloride use, of a drug of anticholinergic, and of the water iontophoresis current by an hour each day had as a result the remission of symptoms during 20 days, compared with 3,5 days for the use of iontophoresis alone; this combination was also more effective in reducing the severity of symptoms. (15) Employing a device for at home use does this accessible hyperhidrosis surgery and relatively economic processing.
Toxin of toxin botulínica Types A
The toxin toxin injections botulínica type A (Botox) they are insurance and effective, and often improves the quality of the life in patients with hyperhidrosis. (16) The toxin inhibits the liberation of acetylcholine in the junction of neuromuscular and affects the postganglionic innervation nice of the glands sudaríparas. (17)
An area approximately 1,2 cm of diameter is done anhidrotic around each place of injection; therefore, multiple injections spaced 1 to 2,5 cm is aside necessary on the areas of hyperhidrotic. The efficacy can be observed in a week. Anhidrosis induced for toxin toxin injections botulínica persists for four to 13 months. (18.19) For the successful long-term therapy, the injections should be repeated regularly.
The injections of Intracutaneous are recommended before that injections of subepidermal, that are too much end to conclusions of nerve. (20) Toxin toxin injections botulínica are painful and they require the use of an anesthetic. Ulnar and median nerve blocks or intravenous regional anesthesia are more troops in preventing the pain that is the trite application of a local anesthetic. (21)
The potential effects of the toxin toxin injections side botulínica include passer-by, the light weakness in the muscles of the hand and the formation of small hematomas in the places of injection. (22) the Cost should be considered also. It can take 100 units (the cost of the acquisition: approximately $426) for each hand. Many doctors charge $1.400 to $1.600 for both palms, and the injections have to be repeated each four to six months. The return to Surpass
Sympathectomy has been carried out since 1920 in patients with incapacitating, hyperhidrosis recalcitrant. Although the procedure be generally enough cash, is permanent and therefore hyperhidrosis natural cure should be considered only after all other therapeutic options have been exhausted. Sympathectomy implies the surgical destruction of the second and third parties nice ganglions excessive sweat antiperspirants and medications for the palms. The risk of permanent sexual dysfunction limits the utility of sympathectomy lumbar for the processing of hyperhidrosis of the plant. (3)
In recent years, the open surgery has been replaced for a most minimum invasive endoscopic focus that has less complications, requires operand less time, and has as a result marking less. It can have still the complications, inclusive reaparición of the hyperhidrosis, to sweat taste, to sweat compensatory in areas previously done not affect of the body (in up at 60 percent of patients), pneumothorax, syndrome of Horner, the neuralgia, atelectasis, the pneumonia, and hemothorax. (23.24) In some patients, to sweat compensatory can be tried really with toxin toxin injections botulínica of intradermal. (25)
The cauterización and holding the methods for the hyperhidrosis surgery sympathectomy excessive sweat antiperspirants and medication endoscopic have been compared in a study of 1.312 patients with hyperhidrosis. (26) All but a patient with hyperhidrosis of palm grove they were cured. Inside the two groups of the cauterización, the rate of the satisfaction was the 94,3 percent for the processing and the 95,1 early percent for late processing; the rate of the satisfaction was the 98 percent in the holding the group. Less than the 6 percent of patients had hidrosis compensatory severe, and the rate of reaparición was the 3 percent. Holding was shown to be at least as cash and sure like electrocautery and had the advantage of is potentially reversible.
Thermocoagulation number of stereotactic of percutaneous in the ganglionectomy T2 and sympathectomy is a newer alternative procedure. It implies the introduction of a tempted of thermocoagulation by the skin of the back after the application of a local anesthetic and the administration of an analgesic one hyperhidrosis natural cure temperate. The procedure can be carried out in a base of outpatient. A study of 1.688 patients with hyperhidrosis of palmoplantar reported a rate of success of 99,5 percent after the initial processing, with a rate of fallen of 7,8 percent after an average of 39 months; all the patients that recajeron were withdrawn successfully, having as a result a final rate of 99,9 percent success. (27) This study did not direct hyperhidrosis compensatory but reported pneumothorax in the 0,2 percent of patients and partial syndrome of Horner in the 0,15 percent of patients.
The force of the Recommendation
The force of clinical Injections toxin recommendation hyperhidrosis surgery Reference Keys botulínica of type toxin B 16 A (Botox) are insurance and effective, and often improves the quality of the life in patients with hyperhidrosis.
The authors indicate that they hyperhidrosis natural cure have no conflicts of interest. The sources of the financing: none reported.
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