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Heart & Vascular Health
woman sweating through shirt

When Sweat Glands Work Overtime

Medical, surgical treatments for hyperhidrosis can help

If you keep a stack of extra shirts in your desk drawer at work, avoid handshakes at all costs or swim in sweat even when you’re outside in the cold, you may have hyperhidrosis.

Hyperhidrosis affects 3 percent of the U.S. population and it can make a soppy, sorry mess of your social life and negatively impact your quality of life. Friends and family who don’t have this condition might say, “Don’t sweat the small stuff,” but hyperhidrosis is no small matter for anyone who is impacted by it.

Excessive sweating isn’t life threatening, but it can make your life miserable. Luckily, non-surgical and surgical solutions are available.

Stunning the sweat glands

Physicians can offer many tests and simple remedies as a first step in controlling hyperhidrosis. Anxiety reduction therapy and medications can help. Other treatment options include special antiperspirants, Botox injections used to stun sweat glands into temporary submission and even a footbath that has a gentle electrical current running through it.

If these treatments don’t work, ask your doctor about surgical options. Your doctor may recommend surgery for severe cases of palmar (hand) or axillary (armpit) hyperhidrosis.

Minimally invasive surgery may help

Video-assisted thoracic sympathectomy (or thoracoscopic sympathectomy) is a minimally invasive procedure. A surgeon interrupts a portion of the main sympathetic nerve that sends a localized signal stimulating excessive sweating. The surgeon treats only the exact nerve bundle that controls a specific region of your body.

This procedure is done under general anesthesia and usually takes less than two hours. Most patients go home the day of surgery.

“There are very few operations that we do where the patient immediately appreciates an improvement in their underlying condition while still in the recovery room. This happens to be one of them,” says thoracic surgeon Sudish Murthy, MD, PhD.

Benefits of minimally invasive surgery

Minimally invasive approaches like the thoracoscopic sympathectomy have benefits over more invasive procedures, including:

  • Limited number of small incisions
  • Shorter hospital stay
  • Reduced pain
  • Rapid recovery time
  • Quicker return to daily activities

Potential risks

As is the case with any type of surgery, thoracoscopic sympathectomy does have risks of potential side effects. The primary side effect is compensatory hyperhidrosis, or sweating in other areas of the body that were once free of sweating. This side effect occurs in approximately 70 percent of all patients, but most patients say they aren’t bothered by it.

Other possible complications include:

  • Artery, nerve or vein damage
  • Cardiac problems, such as abnormal rhythm
  • Blood clots
  • Urinary tract infection

Results

Overall, thoracoscopic sympathectomy relieves symptoms in about 95 percent to 98 percent of patients with excessive hand sweating and approximately 75 percent to 80 percent of patients with excessive armpit sweating. Surgical treatment for hyperhidrosis of the feet is not as effective, with only 25 percent of patients showing improvement.

“No procedure is perfect, and all come with some risks, but impressively, over 95 percent of patients who have undergone thoracoscopic sympathectomy for palmar hyperhidrosis are quite satisfied with the results when surveyed one year later,” Dr. Murthy added.

If excessive sweating has damaged your quality of life and you’ve already tried the non-surgical treatments available, thoracoscopic sympathectomy might be the answer.

Tags: excessive sweating, hyperhidrosis, minimally invasive surgery, thoracoscopic sympathectomy
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  • MSD

    Is the surgery life threatening?

  • fluffy buns

    I’ve tried Certin Dri.. doesn’t work.

  • Helene Sibley

    My sweating is in my face and scalp!! It is extremely embarrassing to see people staring and wondering if I am okay! People stop and ask if I am ok and I have to travel with a wash cloth when it’s warm outside. Is there anything I can do that might help?!!!

    • Judy Matthews

      Me too. It drIves me crazy!!! My hair gets soaked, the sweat runs down my face and not only is my face wet but my makeup is ruined! It doesn’t have to be hot for it to happen. What works?

    • Susan VanderVlucht

      I suffer with severe head/scalp sweating also. It’s worse there than anywhere else on my body! My hair is completely wet after even the smallest of tasks!
      Anyone have any ideas for us sweaty heads?!

      • Helene Sibley

        Yes, that’s me……..my hair is soaking wet most of the time…..talk about having a bad hair day—-every day!!!

        • Susan

          Hi Helene, I’m at a loss as to a solution?? I actually don’t even know what direction to go in – Physical? Psychological? Emotional? Maybe all & more?!
          I have noticed an increase if I’m stressed &/or nervous. Trouble is I’ve been a nervous type all of my life, I’m afraid my body may be trying to counteract my stressors…..sorta physically attempting to rid myself of my own toxic behavior?? Sounds logical /:) but no concrete answers……I’m quite frustrated & ha! Ironically my anxiety just adds fuel to my problem!! /:)

          • Helene Sibley

            Hi Susan, I am not sure that there is a solution. I, quite frankly, have just come to accept that this is just the way it’s always going to be! Spoke to my primary and she told me that there really is no magic pill that would help. I am curious to know if a trip to an endocrinologist would be beneficial?!! I also am a nervous person but I can’t say that I think this contributes to my problem! I have noticed that whenever I have a glass of wine, the perspiration gets worse, But mostly it’s just going about my day to day general activities (cleaning and just moving around) that starts the sweat glands running it’s marathon!!! Living in SC doesn’t help either, although we are here three years only, having relocated here from the northeast where I had the same problem! Frustrated?!!! Yes—–me too! Looks like I just stepped out of the shower 24/7! Geeez!!!

    • judy

      Have you had your hormone levels checked?

  • bestchester914

    By far most embarrassing thing. It completely runs my life and I hate it. Not only is it uncomfortable but knowing I have it only exacerbates the situation which leaves me sweating 24/7. I’m not a candidate for.botox because I indeed one edit one edit for forty other areas. Those Cold technology shirts are a joke. I carry sweat rags and summer is the absolute worst

  • donna rockwell

    What if the sweating is in the entire body for a male taking testesterone shots? Male menopause?

  • Glenn Moran

    I bet in one month with research i can find a mineral based solution without shots or pills. the day of the pharmacy solution is coming to an end.

    Glenn moran

  • Karen

    my husband and daughter suffer from this as well as my mother. One wrong move with the nerve cutting and you won’t sweat period. Not good! None of them had the surgery. My husband is on meds for it. My daughter and mother just deal with it. Their hands sweat profusely. My daughter said the medicated deoderant doesn’t help either.

  • Patti

    Dr. Murthy performed this surgery on me over 6 yrs ago, and it was a total success. I had excessive hand, and feet perspiration along with bothersome armpit sweating. I experienced success in the recovery room! I did have to stay overnite to monitor my lungs because I suffer from asthma. I would do it all over again in a heartbeat!

    I could wear leather shoes for the first time and not ruin them with embarrassing sweat stains. My confidence spiked when meeting new people and shaking hands to holding hands in prayer at church. I wanted to be a professional musician and teacher, but the sweating got in the way when I was a teenager. I ruined the finish on my flute and strings rusted on my expensive guitar. As a reward, I bought myself a sterling silver professional model flute and it remains in gorgeous condition. I can now play professional gigs, as well as, give private music instruction.

    Once, I did experience sweating down my back because I had to take strong pain medication after open heart surgery.

    I

  • Diana Hall

    I sweat all the time. It drips off my face and on my glasses and I can’t do any kind of work. It makes me tired and I have to lay down under a ceiling fan to calm down and cool down. I change my clothers several times a day.

  • Diana Hall

    The doctor doesn’t know what causes it. It has been going on for 5 years now. I can’t be around people. It is embarrassing.