The sweat glands (Glandula suderifera) belong to the so-called skin appendages and are located in the dermis (technical term: corium). The sweat is then released to the surface through the pores of the skin and serves mainly to regulate the heat balance. A further distinction is made between ecrine and apocrine sweat glands.
These differ in function, appearance and location. The ecrine sweat glands are not associated with hair, whereas apocrine sweat glands end in hair follicles. Ecrine sweat glands are found all over the body, while apocrine glands (also called scent glands) are only found in certain parts of the body.
These include the armpits, nipples, genital and perianal regions. The heat balance and pH of the skin is mainly regulated by the ecrine sweat glands. Apocrine sweat glands perform social and sexual functions through pheromone-like scents (pheromones). Primarily, however, they simply determine body odor. Various diseases, however, may require the removal of sweat glands.
Cause Hyperhidrosis
One cause for the removal of sweat glands can be a so-called hyperhidrosis (from Greek (hypér) “even more, about, about … beyond and (hidrós) sweat). Sweating is a completely natural process that is essential for the body’s heat balance. Physiological sweating is therefore beneficial and important for our homeostasis.
It should not be violently suppressed by surgical intervention. But an unpleasant hyperhidrosis can make this necessary. But when is one talking about hyperhidrosis?
Hyperhidrosis occurs when the sweat production in an armpit exceeds 100 mg per 5 minutes. However, this is the scientific limit. Subjectively, even small amounts are perceived as excessive and unpleasant by those affected.
Such a disease is diagnosed by means of tests that can determine the amount of sweat per time. Such tests are, for example, the iodine strength test or gravimetry. In addition to various medicinal and conservative therapies and procedures, surgical measures are of course then available for treatment.
A special form of hyperhidrosis is bromohidrosis (Greek: bromhidrosis). (brômos) goat stench of the animals; (hidrós) sweat) represents a special form of hyperhidrosis. The increased production of sweat creates favorable germination conditions on the horny layer of the skin for the colonization of bacteria.
Degradation products of these bacteria, such as short-chain fatty acids and the amino acid alanine, then lead to an unpleasant body odor, especially in the armpits, the groin area and the spaces between the toes. This unpleasant odor is above all a psychological burden for those affected and can be an indication for the removal of sweat glands. Frequent washing unfortunately does not improve the situation.
In addition to drug therapy, the removal of the sweat glands can also be indicated here. The excision of the sweat glands is a surgical procedure to remove the sweat glands. During this procedure, the affected area of skin is virtually cut out.
The edges are then sutured together. However, it is also possible to remove only parts of the skin in the armpits and then scrape out the sweat glands. This procedure has both advantages and disadvantages that must be considered.
As a radical operation, it removes most of the diseased sweat glands and thus reduces hyperhidrosis to a great extent, unlike minimally invasive procedures that may be able to do so. In return, however, large visible scars and very frequent complications in wound healing occur. The large and deep scars also limit the patient’s mobility.
Furthermore, it is often not possible to cut out all affected areas. Due to these disadvantages, this procedure is used less and less often nowadays. Subcutaneous sweat gland suction curettage is a surgical procedure performed under local anesthesia.
A so-called tumescent solution is used for local anesthesia. This type of local anesthesia offers several advantages. On the one hand, it saves the risks of anaesthesia, on the other hand, the application of large amounts of liquid into the tissue there leads to a good expansion and loosening.
This facilitates the procedure. Furthermore, the risk of bleeding is low, since tumescent solution contains so-called vasoconstrictors, which constrict vessels. Finally, the antiseptic effect of the solution is an advantage.Sweat gland suction curettage is a minimally invasive procedure in which 3 – 4 small skin incisions of about 0.5 cm in length in the armpit usually serve as surgical access.
A special surgical instrument is inserted under the skin through these small skin incisions. The diseased sweat glands are then scraped off with a cannula and then suctioned off. The success rate of this procedure is about 70-80%.
Very good results are achieved because the suctioned sweat glands cannot renew themselves. After one year, however, recurrences may be possible when remaining sweat glands start producing sweat again. The procedure is performed on an outpatient basis and takes between one and two hours. The patient receives a compression bandage and is able to work again after about 2 – 3 days.
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