After Years of Excessive Sweating, Teen Starts High School with Confidence and a Handshake

When 14-year-old Alex Malgarejo first met Dr. Matthew Harting, he didn’t greet him with a handshake. Instead, he sat through the consultation, constantly rubbing his hands on the tops of his thighs – a technique he used often. Malgarejo was suffering from a condition called hyperhidrosis, which caused persistent, excessive sweating in his palms. The embarrassing condition had plagued the teen since he was a child.

“My son suffered from sweaty hands since he was 6 years old,” said Maria Robledo, Malgarejo’s mother. “He could hardly hold a pencil in his hand, and couldn’t avoid his school paperwork getting wet with the sweat from his hands. This led to Alex not being able do a lot of the things he loved, like play baseball and ride horses. Not to mention the mean things that other kids in school would say. We tried everything possible to make it stop, but nothing was working.”

San Antonio natives, Malgarejo and his mother traveled to Houston to seek the help of experts at Children’s Memorial Hermann Hospital, where Malgarejo had been once before. As a child, Malgarejo had a chiari malformation, a neurological disorder where brain tissue extends into the spinal canal. A chiari malformation can cause headaches, balance problems, dizziness, muscle weakness and more. He had been treated by Dr. Stephen Fletcher, a UTHealth pediatric neurosurgeon with Children’s Memorial Hermann Hospital and Memorial Hermann Mischer Neuroscience Institute. The positive experience Malgarejo had at Children’s Memorial Hermann Hospital inspired them to return to see if there was a solution for his hyperhidrosis.

They met with Dr. Matthew Greives, pediatric plastic surgeon with Children’s Memorial Hermann Hospital and assistant professor in the division of plastic surgery at McGovern Medical School at UTHealth. Dr. Greives attempted Botox injections in Malgarejo’s hands.

“Just like we use Botox to decrease wrinkles, it can also work on the nerves that cause your sweat glands to secrete,” said Dr. Greives. “We start with about 25 injections in each hand every three months. However, Alex’s case was a bit more extreme and the Botox injections weren’t properly stopping the sweat from occurring.”

To explore Malgarejo’s case even further, Dr. Greives partnered with Dr. Matthew Harting, pediatric surgeon with Children’s Memorial Hermann Hospital and assistant professor in the division of general and thoracic pediatric surgery at McGovern Medical School at UTHealth. On June 30, 2017, Dr. Harting performed a surgery on Malgarejo called a thoracoscopic sympathectomy.

“The procedure requires very small incisions under the armpits,” said Dr. Harting. “We use a special camera to look in and see the nerves that run inside the chest that provide stimulation to the sweat glands. If we sever the nerve in the correct place, we can stop the excessive palmar sweating completely.”

Malgarejo’s surgery was a success, just in time for the start of his freshman year of high school.

“It’s not embarrassing anymore because my hands don’t sweat,” said Malgarejo. “Before the surgery, I couldn’t even pitch a baseball because the ball would slip out of my hand. Now I can shake the hands of my classmates without feeling ashamed.”

For more information about Children’s Memorial Hermann Hospital, or to schedule an appointment, visit the Children’s Memorial Hermann Hospital website.

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