Surgery
for sweating
There is a group of patients who sweat
excessively from the hands, armpits or face. At its worst
this condition (hyperhidrosis), which predominantly affects
young people, can be disabling preventing patients from
working, doing schoolwork or socialising. Medical treatment
for this condition is sometimes but often not effective.
The symptoms are excessive sweating of the hands and / or
armpits. There may be associated sweating of the face or
facial flushing and often the feet are affected also.
Symptoms occur throughout the year and may be worse in
stressful situations. Typically beads of sweat appear which
may make manual work and writing difficult, or stain
clothes which may require frequent changes. Facial flushing
and sweaty palms can be a socially embarrassing condition.
Antiperspirants may help with axillary sweating. Aluminium
based compounds are effective but often cause unacceptable
skin irritation. Drugs are available to cut down sweating
in general but often cause intolerable side-effects. For
localised axillary sweating Botox injections can be helpful
although the effect only lasts for a few months and the
treatment needs to be repeated at intervals.
Thoracoscopic sympathectomy is an operation designed to
deal with excessive sweating. It is particularly suitable
for patients with a problem mainly affecting the hands and
/ or the armpits. In this group of patients the success
rate is close to 100% with a very low recurrence rate. It
is also successful in relieving the symptoms of facial
flushing, although the success rate is not quite as high in
this group (approximately 75%).
The operation is performed through two tiny (5mm) incisions
in each armpit. A piece of nerve called the sympathetic
chain is identified and a small part of it destroyed. Apart
from some backache for a few days the patient will
experience very little discomfort and the operation usually
only requires an overnight hospital stay.
Side effects include compensatory sweating (excess sweating
from other areas) but this is usually much less troublesome
than the original complaint.
For more
information please visit our 'Patient Information' page where
you can download information sheets relating to the
specific operations.