Frequently Asked Questions about Hyperhidrosis Treatment

We can treat mild forms of hyperhidrosis without surgery. The most common approaches include use of astringents, talc or starch, sedatives, antihistamine medicines, or beta blockers. We can also try more aggressive therapy such as liposuction, botulinum toxin injections, or iontophoresis. If these do not work, we can offer surgical treatment.

What is the surgical treatment for hyperhidrosis?
The most effective treatment for hyperhidrosis is endoscopic thoracic sympathectomy (ETS), a surgical procedure. We use special equipment to cut the sympathetic nerves at a precise location. The surgery takes about 40 minutes and requires two small (about 1.5 centimeters) incisions, one on each side of the chest. We use a camera so we can see the nerves. This procedure affects only the nerves to the armpits and hands. We do not use this procedure to treat the nerves to the face or feet.

What are the results?
You should see a dramatic improvement practically from the moment you awaken from the anesthetic. These effects are permanent for almost everyone.

What is the recovery period?
Although ETS is a minimally invasive surgical procedure, you may feel some pain shortly after the surgery. Most people only feel pain by the incision sites and the nerves near the incisions. You may also feel some chest discomfort for the first one to three days after surgery. Most patients return to normal activity after about a week. Your body continues to heal after any surgical procedure for weeks or months. In some patients, the healing process will take a little longer. People with diabetes and people who smoke tend to take longer to heal.

What kind of anesthesia is used?
We use general anesthetic for this surgery. You should be able to leave on the same day of surgery.

What are the risks of surgery?
When an incision is made, there is a small risk of infection, bleeding, or healing issues at the surgical sites. We use general anesthesia, so there are the risks associated with that process. Some patients have bad reactions to medications used. Your surgeon will discuss the surgical risks with you in greater detail.

What are side effects of surgery?
The most bothersome side effect is excessive sweating on the back, abdomen, thighs, or lower legs. We call this compensatory sweating. All patients have some degree of compensatory sweating and it ranges from mild to severe. A small percentage of patients (3-5 percent) experience more severe compensatory sweating. We consider it to be severe when it soaks through the clothing. It is a difficult situation especially in hot, humid days. Doctors have not determined who is most likely to experience severe compensatory sweating.

Most patients who develop mild to moderate compensatory sweating say that they are not troubled by this extra perspiration. They find it better than the sweaty palms they had before the procedure. Patients who do develop severe compensatory sweating may have difficulty during hot humid weather or anxious situations.

Some patients have a temporary recurrence of sweating on their palms three or four days after the operation. Usually this lasts no more than half a day.

A surgeon will discuss this with you before surgery. Don't be afraid to ask any questions you may have.