Hyperhidrosis: When Your Sweat Glands Are Working Overtime

Medical, surgical treatments for hyperhidrosis can help
woman sweating through shirt

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.

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Hyperhidrosis affects 3% 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.

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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% of all patients, but most patients say they aren’t bothered by it.

Other possible complications include:

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


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

“No procedure is perfect, and all come with some risks, but impressively, over 95% 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.

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