CENTER FOR EXCESSIVE SWEATING

Dr. Karamanoukian was one of the very first doctors in the U.S. to perform the ETS procedure using robotic devices (1999, Zeus and AESOP; Computer Motion Inc). He continues to perform a less invasive version of the micro ETS procedure called STITCH. He performs a large number of STITCH procedures a week. He also provides every type of treatment for hyperhidrosis, including medical, Botox, suction curettage and STITCH.

Dr. Karamanoukian's primary focus is helping those who suffer from hyperhidrosis and improving the methods used to accomplish that goal. A secondary goal is to teach other surgeons to perform this procedure in a safe and effective manner.

If you experience profuse sweating of the palms, underarms, feet, and/or face, you may have rimary hyperhidrosis. This is the type of hyperhidrosis that is amenable to surgical correction if conservative medical therapy fails to correct this problem.

Primary hyperhidrosis is excessive sweating beyond physiologic sweating which results in profuse sweating of the palms, underarms (axillae), feet (plantar) and face.

What is considered excessive sweating? Epidemilogic studies and physiologic studies have shown that any amount of sweating that is considered "excessive" by the individual who is having it is considered hyperhidrosis. Although studies that measure the amount of sweat can be done, they are cumbersome and not practical. Measuring the exact amount of sweat by collection techniques are not considered practical is most clinical practices.

Hyperhidrosis is a nonthermoregulatory sweat response that results from excessive cholinergic stimulation of the eccrine glands from the sympathetic trunk.

The eccrine sweat glands are the sweat glands that secrete water and electrolytes. Excessive function of the eccrine sweat glands causes hyperhidrosis. Excessive stimulation of the apocrine sweat glands causes bromhidrosis (excessive smell or odor). The apocrine sweat contains bacteria and bacterial products that accomany the hair follicles and are responsible for the excessive odor in some individuals who have excessive sweating.

Hyperhidrosis is of unknown etiology and afflicts 10% of the population in one form or another.

What is known about hyperhidrosis is that it causes severe occupational, emotional and social distress.

Patients describe hyperhidrosis of the palms as so debilitating that it interferes with their social interaction with others.

They cannot shake hands with others for fear of "sweating" and "turning off" business acquaintances or friends, social friends and sexual mates.