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.