Hyperhidrosis (HH) is a commondisorder characterized by excessive sweating beyond physiological needfor thermal regulation.1,2It can significantlyimpair an individual’s quality of life.3Hyperhidrosis can be classified as being primary or secondary. Primaryhyperhidrosis (PH) occurs due to over-activity of the sympatheticnervous system; however, the cause of this over-activity is unknown. Primaryhyperhidrosis usually presents symmetrically and often affects the armpits,palms, and soles.
Secondary hyperhidrosis (SH) can be attributed to knownfactors including: infections, antidepressant use, neurologic abnormalities,diabetes mellitus, excessive stress, and obesity. However, both primary andsecondary hyperhidrosis, can negatively affect daily social and physicalactivities and lead to psychological distress. Several clinical treatments havebeen used to treat hyperhidrosis, including antiperspirant use, iontophoresis,anticholinergic drugs such as oxybutynin, and local botulinum toxin Ainjections. However, these treatments often provide relief in only a smallfraction of patients, have numerous side effects, can prove to be costly, andoften lose their effectiveness over time. Sometimes, clinical treatments may depend on the location ofhyperhidrosis. In example, the topical anticholinergic agent glycopyrrolate,oxybutynin, and intradermal botulinum toxin A injections have been described asfirst-line therapies for facial hyperhidrosis (FH) due to their efficacy andfavorable safety profile.41 Single-port one-stage bilateralthoracoscopic sympathicotomy for severe hyperhidrosis: prospective analysis ofa standardized approach2 Evaluation of the quality of life of patients with primaryhyperhidrosis submitted to videothoracoscopic sympathectomy3 Single-port one-stage bilateral thoracoscopicsympathicotomy for severe hyperhidrosis: prospective analysis of a standardizedapproach4 Video-Assisted Thoracoscopic Sympathectomy for FacialHyperhidrosis: The Influence of the Main Site of Complaint