Hyperhidrosis: Evolving concepts and a comprehensive review

Hyperhidrosis (primary or secondary) describes a disorder of excessive sweating It has a significant negative impact on quality of life and affects nearly 1% of the population living in the United Kingdom (UK). Axillary involvement is the most common affecting 80% of cases A common link to these disorders is an extreme non-thermoregulatory sympathetic stimulus of exocrine sweat glands, mostly due to emotional stimuli Non-surgical treatment involves topical medication, iontophoresis and systemic anti-cholinergics More recently the use of intradermal botulinum toxin has gained popularity Surgical treatment reserved for severe cases, not responding to conservative management involves local excision, curettage and thoracoscopic sympathectomy Evolving concepts for treatment, risks and benefits are discussed in the paper herein (C) 2010 Royal College of Surgeons of Edinburgh (Scottish chanty number SC005317) and Royal College of Surgeons in Ireland Published by Elsevier Ltd All rights reserved