Treatments

Dr. med. Oliver Ph. Kreyden is the senior medical officer of Kreyden Hyperhidrosis. He’s one of the leading specialists in Switzerland, has written various papers and is a well-known speaker at international conventions on the subject. All patients who choose a course of therapy for hyperhidrosis are looked after by Dr. Kreyden personally, both before and after treatment.

Botulinumtoxin

By injecting Botulinum toxin into the skin, sweating can be reduced by 70 to 90 percent, although patients with more pronounced hyperhidrosis tend to benefit more from the treatment than those with moderate hyperhidrosis. This is due to the fact that 90% of a larger amount of sweat is subjectively considered a greater success than the same reduction with less perspiration, volume-wise.

Around the armpit, the injections are given without local anaesthesia. The treatment is uncomfortable, but not painful. Each armpit is injected ten times. Before treatment, the designated area in and around the armpit is marked with an iodine-starch reaction, the so-called Minor-Test. With the hands and feet, the palms or soles are first treated with a local anaesthetic. Kreyden Kyperhidrose has developed its own method, which is appreciated greatly by the patients treated.

Iontophoresis

Iontophoresis is a treatment method in which a mild electrical current is passed through water by a medical device. This causes the sweat glands to eventually slow – or stop – their activity. The treatment has to be done twice daily for the first ten days, for a duration of 15 minutes. Once a decrease or suspension of sweating inclination has been achieved, the course of therapy can be completed. In practice, it has been shown that the therapy usually has to be repeated one to six weeks after the initial run, anywhere between two and six times.

Surgery

If the chosen treatments don’t lead to the desired outcome, a surgical treatment can be taken into consideration. With axillary hyperhidrosis, Kreyden Hyperhidrosis recommends subcutaneous sweat gland suction curettage, and for palmoplantar hyperhidrosis, a thoracic endoscopic sympathectomy (TES). Kreyden Hyperhidrosis works closely with the department for thoracic surgery at the University Hospital of Basel, guaranteeing a professional operation in the hands of an experienced team.

Eliminating axillary sweat glands with microwave technology

This new, non-invasive microwave treatment cauterises subcutaneous sweat glands. It is done under local anaesthetics and is an ambulant treatment. One can assume that a single treatment can bring a 50 to 70% improvement (depending on the severity of the hyperhidrosis). Therefore, some patients need two treatments to achieve a satisfying result.

Subcutaneous sweat gland suction curettage

For axillary sweat gland suction curettage, only very small incisions are needed in order to vacuum (or scrape out) the sweat glands, which are located in a layer of subcutaneous fat. Due to a high relapse rate, this treatment is only recommended conditionally, and with special indications.

Thoracic endoscopic sympathectomy

Under general anaesthesia, the nerves responsible for sweating are surgically severed near the spinal cord. This method has the advantage of being a conclusive solution. Additionally, it is the recommended course of action when Iontophoresis or Botulinum toxin treatments have previously failed. The drawback of this treatment is that numerous patients go on to develop so-called compensatory sweating. For this reason, this method should only be chosen when all other treatments fail.

Oral Therapy

A treatment with medication for hyperhidrosis can be considered in the case of (by trend) generalised hyperhidrosis. In doing so, the receptors of the autonomic nervous system are filled by the drug (receptor blockers). Because this is a systemic therapy method, possible side effects need to be taken into consideration. Additionally, due to its short half-life, the duration of action relatively short, and the medicine must be taken multiple times a day. Therefore, the diagnostic evaluation must be weighed up accurately.

 

naloo
Praxis Methininserhof
Dr. med. Oliver Ph. Kreyden, Dermatologie FMH