July - September 2010 Edition: Naples Health

In the Spotlight

Big Problem? Don’t Sweat It W e all sweat from time to time, but imagine sweating so profusely that you are embarrassed to shake hands or are afraid to wear certain colors for fear of noticeable stains. Such situations face people who suffer from hyperhidro- sis, commonly known as excessive sweating.

The problem was no joke for Isabelle Watzinger, a 19-year-old theater student at Florida Gulf Coast University. “I had the problem for I don’t even know how many years,” she says. “Shaking hands was difficult, and I couldn’t wear certain clothes. I got made fun of a lot. Other kids teased me and put me down for something that wasn’t my fault.” Neither Watzinger nor her mother had ever heard of hyper- hidrosis, so they didn’t know what to do about her sweating. Both assumed it was something she would have to learn to live with, until Watzinger’s mother saw a story in the Naples Daily News about the condition. That led them to Scot Schultz, M.D., a cardiovascular and tho- racic surgeon with Gulfcoast Cardiothoracic Surgeons, who has treated more than 25 people for the condition within the past year. He explained that hyperhidrosis affects up to 3 percent of the population, tends to run in families and usually manifests during adolescence or early adulthood. There are three common areas where hyperhidrosis appears: the feet, the underarms and the hands. Facial hyperhidrosis, or excessive sweating of the face, is less common. It is important to determine the severity and location of the excessive sweat- ing, as treatment options vary depending on the site. “For plantar [foot] hyperhidrosis, there are systemic medi- cines, such as alpha blockers that essentially dry up the body,” Dr. Schultz reports. “Side effects are not uncommon and include dizziness, dry eyes and blurry vision. There is also iontophoresis, a chemical bath with electric stimulation that can block the sweat glands in the feet. However, this is a lifelong treatment, and each bath is up to 45 minutes daily.” For axillary [underarm] hyperhidrosis, prescription-strength deodorants should be tried as first-line treatment. Botox injec- tions have also been somewhat successful, but they must be

Isabelle Watzinger and Scot Shultz, M.D.

repeated every three to six months, as effectiveness is short- lived. Botox can also be used to treat palmer (hand) hyper- hidrosis, but since that requires about 25 injections in each hand, it is painful and not very practical. For patients like Watzinger, who have excessive sweating in all three areas, Dr. Schultz recommends endoscopic thoracic sympathectomy (ETS), a surgical procedure that interrupts sections of the sympathetic nerve through one or two small (5 mm) incisions in the armpits. Compensatory sweating may develop elsewhere on the body, such as the back or legs, but it is rarely a significant issue with advancements in the proce- dure and in younger patients. Watzinger had the surgery in November 2009 and couldn’t be happier with the results. “It was definitely life-changing,” she says. Dr. Schultz offers free screenings for ETS. For more informa- tion, contact his office at (239) 649-0440.

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Naples Health | JULY-SEPTEMBER 2010

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