Publicado em: qua, jan 23rd, 2013

Suor excessivo, doença que afeta a qualidade de vida, pode ser tratada com cirurgia

No Instituto do Radium de Campinas, médico especialista realiza o procedimento cirúrgico para a cura da Hiperidrose, doença que acomete cerca de 140 milhões de pessoas no mundo

 dicas06Suor excessivo, seja no calor ou no frio, daqueles que deixam rosto, cabeça, axilas e mãos molhados, muitas vezes, inclusive, logo após o banho, água escorrendo pelo braço e pelo corpo, roupas manchadas, odor forte, pés frios ou molhados, mãos frias ou inchadas. Esse é o diagnóstico da Hiperidrose, uma doença caracterizada pelo suor excessivo localizado. A Organização Mundial de Saúde classifica a Hiperidrose como uma doença funcional que não acarreta nenhum mal orgânico, permitindo que a pessoa conviva com o problema, mas a caracteriza, em todas as suas variações (mãos, pés, axilas e craniofacial) como uma doença limitante e constrangedora, e recomenda que ela não seja avaliada apenas sob o aspecto estético.

“Essa doença causa um grande desconforto para quem a apresenta, gerando vários tipos de limitação funcional, fobias e constrangimentos, incapacidades específicas e até riscos ocupacionais, dependendo da profissão que exerce. Todos estes problemas ocorrem em graus e em situações variados, de acordo com a sensibilidade e experiência de cada um”, explica o cirurgião torácico Marcelo Manzano Said, do Instituto do Radium de Campinas.

A Hiperidrose acomete cerca de 140 milhões de pessoas no mundo, que representam 2% da população mundial, igualmente a homens e mulheres com pequenas diferenças nas prevalências e nas idades. Ela pode aparecer desde a infância até a idade adulta e caracteriza-se pelo suor excessivo que pode ser nas mãos, nos pés, nas axilas, no rosto e no couro cabeludo, juntos ou em separado.

“Como a única função do suor é perder calor e auxiliar no controle da temperatura corporal (termoregulacão), a Hiperidrose não causa nenhum problema nos órgãos e nas suas funções. No entanto, muitas vezes o suor excessivo é acompanhado de vermelhidão no rosto e no tórax (rusching cutâneo ou Síndrome do Palco); odor forte (bromohidrose); mancha nas roupas (cromohidrose); cheiro forte nos calçados (chulé) e de mãos ou pés sempre frios”, acrescenta o médico. Assim, frequentemente, aqueles que procuram o tratamento para a Hiperidrose o fazem em busca de melhorar a qualidade de vida em relação ao suor.

Sobre a Hiperidrose  

Como a produção do suor para perda de calor é um controle autônomo do nosso organismo, o seu estimulo independe da nossa vontade. Por este motivo não conseguimos controlá-lo. Quando menos queremos basta pensar ou ficar ansioso que o suor vem. Quem manda este estimulo para a glândula do suor é o nervo autônomo chamado Simpático (palavra de origem latina que quer dizer paralelo), por estar paralelo à coluna vertebral nas regiões do tórax e lombar nos lados direito e esquerdo.

Por um motivo constitucional individual algumas pessoas têm um desequilíbrio na função deste nervo,  provocando um excesso de estímulo para as glândulas do suor. “Não há causa psicológica porque a disfunção é autônoma, mas, sem dúvida, muitas pessoas ficam constrangidas, limitadas, envergonhadas, nervosas e ansiosas com a Hiperidrose. O tratamento existe e é eficaz para todos os tipos de apresentação da doença”, explica o médico.

Tratamento
Essa doença é de diagnóstico clínico, e pode ser identificada até por um médico assistente que deve direcionar o paciente para o tratamento especializado, realizado por um dermatologista. O tratamento pode ser clínico e o cirúrgico. Se a opção for pelo tratamento clínico, a indicação é a iontoforese, aplicação diária por 30 minutos de pequenos choques em cada região acometida por um aparelho eletrônico e uma placa. São pequenos choques totalmente suportáveis que impedem que o estímulo do suor chegue até as glândulas. O resultado é parcial e não definitivo.

Outro tratamento é a aplicação de toxina botulínica (Botox). Nesse caso, são aplicadas injeções com uma agulha subdérmica (bem pequena) nas regiões acometidas. O resultado é bom e a reaplicação deve ser feita em média a cada seis meses.

No entanto, o tratamento cirúrgico (simpatectomia torácica por videotoracoscopia) é o mais indicado porque tem os melhores resultados, é definitivo, apresenta baixo risco e custo menor com benefício maior e pode ser feito para todas as formas de Hiperidrose. A cirurgia deve ser realizada por um médico cirurgião de tórax habilitado em videocirurgia (técnica de cirurgia minimamente invasiva, que necessita apenas de duas incisões de cinco milímetros em cada lado no tórax do paciente, na região axilar. Nesta região as cicatrizes muito pequenas ficam escondidas e com um resultado estético perfeito.

A simpatectomia torácica por videotoracoscopia é realizada em hospitais ou hospitais dia (day hospital) e os pacientes têm alta
em menos de 24 horas. O retorno ao trabalho ou à escola é liberado em dois dias e, as atividades físicas, em 10 dias. O resultado da cirurgia é definitivo e excelente para as regiões acometidas com evidente melhora na qualidade de vida.

A cirurgia traz também mudança no comportamento do suor que aparecerá em outras regiões (normalmente abdômen e costas) todas as vezes que a pessoa operada precisar suar, portanto quando estiver calor ou durante atividades físicas.

Sobre o Autor

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