Excessive sweating or hyperhidrosis is caused by a dysfunction in the sympathetic nerve chain. A patient suffering from hyperhidrosis will find himself sweating beyond the physiological need of the body to maintain a regulated temperature. The Body parts most commonly affected are the hands (Palmer Hyperhidrosis), feet (Planter Hyperhidrosis), face (erthrophobia), and armpits (axillary sweating). Experts have found that there is in fact a genetic component in this condition. In about 40% of the cases there is a family history of hyperhidrosis although not everyone knows of a family member who suffers from this ailment. In cases here there is no family history, the patient may be the first to carry these genes. Regrettably, hyperhidrosis is a life long condition and does not go away without treatment.

Surgical Options
There have been significant advancements in the treatments available to overcome hyperhidrosis. Earlier, surgery to treat this condition was complicated and considered risky. Today, a procedure called Endoscopic Thoracic Sympathectomy (ETS) is available to patients, which claims to offer a life-long solution. This is a minimally invasive procedure done, as the name suggests, endoscopically, on the spinal sympathetic nerves. It is performed on an outpatient basis, which means that the patient returns home the same day. It is extremely precise and the complication rate is very low. There are two methods ?cutting and clamping. In the former the nerve is cut, either by electric cautery, or a harmonic scalpel (ultrasound device). In the latter the segment of the nerve that is causing the problem is clamped with titanium clips. The clamping method is reversible while the cutting method is not.

Although it considerably reduces sweating in the armpits and palms, the effect may not be permanent. The reason for recurrence is not known. It could be due to re-growth of the nerve that has been clamped. Also, the patient may develop compensatory hyperhidrosis in other parts of the body. Post procedure, the patient may also develop dryness and an unfavorable skin warmness. It is not recommended for patients suffering from Planter Hyperhidrosis as it may impede sexual functions of the body.

Non ?Surgical Options
There are also non-surgical treatments for hyperhidrosis. These include BOTOX? lotions, pills, electronic devices, acupuncture, anti-anxiety medications, beta blockers, biofeedback, and herbal medicines.

Oral Medication: Similar to those used to treat peptic ulcer, these anticholinergic medications such as Robinul, Ditropan? and Pro-banthine?, have limited success. Side-effects include blurry vision and dryness in the mouth.
Beta Blockers: are helpful, but not suitable for people with asthma or vascular diseases.

Electronic devices: Drionic is an electric machine that uses iontophoresis to reduce the production of sweat. A weak electrical current is passed across the hands which are soaked in water. This treatment needs to be done on a regular basis, although success rate is limited.

BOTOX?: This is a short-term treatment for hyperhidrosis, its effects lasting for only three to six months. It is becoming increasingly popular for treatment of axillary hyperhidrosis. However, its use for treating sweaty palms and soles has not been approved by the FDA. You may need local or general anesthesia, as these injections can be quite painful.