Definitions and Glossary of commonly used excessive sweating,
hyperhidrosis related terms
Choose a word or term below for detailed information:
- A -
Anticholinergic Drugs
A group of medications (Robinul, Ditropan, Propantheline) which
should be used as the first line of treatment for patients who
suffer from excessive hand sweating - palmar hyperhidrosis. This
medication should be given by a physician and should be followed
to see if there is any relief from hand sweating. Those who take
those medications should keep records and receipts as proof of
conservative treatment for their problem. It should be emphasized
that any patient who considers surgery should try some of the
alternative methods.
See also our Alternative Treatments section.
Apocrine sweat glands
There are two types of sweat glands, eccrine and apocrine. The
apocrine glands are located in the groins armpit areas and also
in the facial regions. They are secreting more oily secretion
rather the watery type of sweat. The apocrine glands are not
usually affected by sympathectomy.
Axillary Hyperhidrosis
Excessive sweating in the armpit area. To learn more about this
we suggest you visit Dr. Alon Pnini's website. Dr. Pnini is a
leading expert in the field of Superficial Suction Curettage,
known to be the most effective surgical alternative to ending
excessive armpit sweating.
Azygos Lobe
A term used to describe an anatomical abnormality which occurs
in about 1% of the population. It describes a situation in which
part of the right lung is covered by a vein and veil. It has
no psyiological significance and when sympathectomy is being
done on the right side it can pose some difficulties when performing
the operation.
- B -
Beta Blockers
A group of medications being used for the treatment of certain
heart problems. Can be used for the treatment of facial blushing
and social anxiety with some degree of success. Should be given
by a physician and followed by a physician.
Bromhidrosis
Medical term describing excessive axillary sweating, dark in
color producing odor. Bromhidrosis (odor) represents a variation
or accentuation of normal axillary odor. It is very bothersome
and can cause a lot of problems for people socially.
BOTOX®
A chemical product from certain bacteria that in its purified
form can be used for the treatment of focal hyperhidrosis such
as axillary sweating. This is not approved for the treatment
of palmar hyperhidrosis.
- C -
Clipping
In the clipping/clamping method, titanium clips are applied on
the nerve causing the cessation of function of that particular
segment. One should be aware however that removal of the clips
does not have the same results for reversibility and there are
many factors that will determine the likelyhood of success when
the clamps are removed.
Compensatory Sweating
A side effect to ETS (Endoscopic Thoracic Sympathectomy). Most
everyone experiences some degree of compensatory sweating however
in most cases it is preferable to the original excessive sweating.
Other words used to describe the same situation is "reflex
sweating." The exact physiological explanation is known
yet. It does not affect every patient the same way so there must
be some individual factors that contribute to this.
Cutting
A term used to describe the method by which the nerve is destroyed
by electrocautery, harmonic scalpel, or excision of a nerve segment
during sympathectomy.
- D -
Drysol
An aluminum compound that is used for the treatment of palmar
hyperhidrosis. It comes in different strengths (10%, 20% and
30%) and should considered as one of the first approaches for
the treatment for excessive hand sweating. Drysol should be obtained
from a physician and those who use it should keep receipts of
their treatment.
- E -
Eccrine Gland
The eccrine glands are the glands producing sweat. The body has
millions of these glands which are affected when the ETS surgery
is performed.
ETS
ETS is an acronym for Endoscopic Thoracic Sympathectomy. This
is the procedure performed to cure people of excessive sweating.
- F -
Facial Blushing
A clinical situation in which the patient describes redness and
heat sensations in their face mainly occurring in social situations.
Thought to be potentially treated with ETS but here the success
rate is not as good for excessive hand sweating. ETS fell out
of favor in treating this entity due to more side effects than
previously thought.
Facial Sweating Physiological condition in which the facial
area and the scalp are sweating more than is needed. Those who
suffer from this excessive sweating describe it as very damaging
to their functional and social life. Endoscopic Thoracic Sympathectomy
thought to be a remedy for that but unfortunately those patients
who were operated on only for excessive facial sweating developed
(statistically speaking) more severe compensatory sweating. At
present Dr. Reisfeld does not recommend (ETS) for this particular
problem. Medication such as anti cholinergic medications, mild
sedatives should be tried before any consideration for surgical
treatment is given.
See also Alternative Treatments Section
- G -
Gustatory Sweating
Sweating of the face, forehead, scalp, and neck. Appears as a
response to spicy food, sour food, in the normal population.
Described as a side effect after endoscopic thoracic sympathecoty,
and it was up to 10% of the patients who underwent ETS. Since
Dr. Reisfeld lowered the level of ETS to level T3 - T4 the number
of patients who suffer from gustatory sweating as a side effect
of ETS fell dramatically. The psyiological explanation for this
is that the newer technique maintains the para-sympathetic and
sympathetic balance in tact.
Ganglia
A mass of nerve tissue or a group of nerve cell bodies. This
is used to describe where connections are made between one sympathetic
area to another.
- H -
Hemothorax
Bleeding in the chest.
Horner Syndrome
A complication that can result from sympathectomy. Dr. Reisfeld
has never had a Horner Syndrome case in all his years of practice
(21+ years).
Horner Syndrome is characterized by Sinking in of one eyeball,
ipsilateral ptosis (drooping of the upper eyelid on the same
side) and miosis (constriction of the pupil of that eye) together
with anhidrosis (lack of sweating) and flushing of the affected
side of the face.
The Horner Syndrome was a relative common complication when
sympathectomy was done through the open approach through the
neck. It happened in up to 15% of the cases. Performing the operation
endscopically now a days cut the incidents to a very negligible
number (less than 0.001%).
Hypersympathetic
Activity
A physiological situation in which patients have excessive outpouring
of sympathetic mediators such as adrenaline can result in excessive
hand sweating (palmar hyperhidrosis), anxiety, palpitations,
etc.
- I -
Iontophoresis
Treatment / Drionic
A conservative method to treat palmar hyperhidrosis is the use
of the drionic machine or the Fisher Iontophoresis equipment.
Those instruments are sending mild electrical shocks to the palms
of the hands of the plantar surface of the feet and by doing
so changing electrical balance across the membrames in the sweat
glands. One has to use it very often and it can cause some pain
while using it. Never the less a patient should try iontophoresis
as a treatment for their excessive hand sweating before a decision
is made to go for surgery.
Intercostal nerve
graft
A method described by Dr. Lin from Taiwan to restore continuity
of the sympathetic chain for those patients who wanted a reversal.
So far no definite data of proven success is available.
- J -
- K -
Kuntz Nerve
Dr. Reisfeld believes that the Kuntz nerve is a misused term.
In the 1920's, Doctor A. Kuntz wrote a paper regarding a nerve
he found in cats. That paper was written about the high failure
rates when sympathectomies were done for vascular problems with
the hands. We know now that the failure rate in those types of
operations are related to post-denervation hypersensitivity.
In the last symposium on sympathetic surgery in Finland, the
overall consensus was that the Kuntz nerve has no bearing on
the failure rate of sympathectomy (the actual ETS operation).
- L -
Lobe
The lungs are divided into lobes. There are three on the right
side and two on the left side.
Lumbar Sympathectomy
Over the last 15 years when thoracic sympathectomy became more
and more widespread it became evident that excessive foot sweating
(plantar hyperhidrosis) was not helped as much as palmar hyperhidrosis
(hand sweating) after ETS. Since 2006 Lumbar Sympathectomy was
added to the surgical options to treat excessive foot sweating.
To learn more visit our excessive foot sweating page.
- M -
- N -
- O -
Orthostatic Hypotension
A clinical description that describes a fall in blood pressure
that occurs when a person assumes a standing position usually
after a prolonged period of rest. Usually it does not happen
after limited endoscopic thoracic sympathectomy is done at the
level of T3-T4. In case reports where it was described after
ETS it usually involved cases of multiple level sympathectomies.
Related information Syncope
- P -
Palmar Hyperhidrosis
A physiological condition describing excessive hand sweating
beyond the physiological need. Obviously there are different
levels to excessive hand sweating and it can range for mild cases
of moisture to severe cases of water drops dripping from the
hands. See also our Palmar Hyperhidrosis page.
Parasympathetic
The parasympathetic nervous system together with the sympathetic
nervous system (that accelerates the heart rate, constricts blood
vessels, and raises blood pressure) constitute the autonomic
nervous system, the branch of the nervous system that performs
involuntary functions.
Plantar Hyperhidrosis
A physiological condition describing excessive sweating of the
feet, beyond the physiological need. Most patients who have sweaty
hands will also have sweaty feet, known medically as Plantar
Hyperhidrosis. Even though it is not as severe as hand sweating,
functionally or socially it still poses a problem. Shoes can
be ruined, sandals cannot be worn, and foot odor and fungal infection
can become problematic. It can lead to marital problems as well
as difficulties at the working place. The odor and the discomfort
caused by excessive foot sweating (plantar hyperhidrosis) can
lead to difficulties that are not well known in the medical community.
At times the severity of Plantar Hyperhidrosis is as bad as Palmar
Hyperhidrosis.
Pneumothorax
Free air in the chest outside the lung.
- Q -
- R -
Retrograde Ejaculation
This describes a situation where part of the semen ejaculate
partially goes back to the bladder instead of coming forward
through penis opening. An incorrect and misunderstood fear is
that lumbar sympathectomy causes this problem. As long as lumbar
sympathectomy is done below the level of the second lumbar vertebrae
this condition should not happen.
Reversal
This is related to the reversal of the ETS procedure. The method
to accomplish this depends on the type of ETS procedure performed
as well as other factors. For more information on this please
view click here.
- S -
Sympathetic Nerve
System
Area of the nervous system that serves to accelerate the heart
rate, constrict blood vessels, and raise blood pressure. The
sympathetic nervous system and the parasympathetic nervous system
constitute the autonomic nervous system, the branch of the nervous
system that performs involuntary functions.
- T -
T Levels
A common terminology used by surgeons who perform ETS to describe
where the sympathectomy was done (clamping vs. cutting). The
T stands for the area of the sympathetic of the chain parallel
to a specific rib. T2 means second rib, T3 means third rib, and
T4 means fourth rib.
*These statements have not been
evaluated by the FDA, and are not meant to diagnose, cure or
treat any disease.
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