Treating Excessive Sweating With Surgery


Imagine this. You’re about to pitch your big idea to one of the top brands in this country and all the brass are in there. Aside from the concern of disappointing them, your hands are shaking and you can’t seem to focus. You try to channel the inner zen and calm yourself as the execs went into the room. You’re about to start your presentation when you saw an executive whisper to another, smirking. Soon, everybody in the room is all red and about to burst into laughter. You are wondering, “What is wrong with these people?” Your boss walks towards you and whispers “Your underarms are sweating and your clothes are showing them.” Quite embarrassing, right?

Excessive Sweating

Now, imagine if you are a person suffering from Hyperhidrosis, commonly known as excessive sweating. You sweat profusely from your face, underarms, hands, and feet. If a common thing such as underarm sweat is embarrassing, how much more with these people who can’t control it and are maybe withdrawn from social situations.

What Causes Hyperhidrosis?

The primary cause of Hyperhidrosis hasn’t been singled out yet. Before, people thought it was just a psychological issue that is involved with the mental and emotional state of a person. However, some studies have shown that genes play a part in hyperhidrosis, or in other terms, hereditary. Other related causes are heart diseases, diabetes, obesity, gout, alcohol abuse, pregnancy, respiratory failure, substance abuse and many more.

How Do Doctors Diagnose Hyperhidrosis?

A doctor can rule out certain conditions such as overactive thyroid or low blood by ordering blood and urine tests. There are also certain guide questions that will determine if the patient is indeed suffering from Hyperhidrosis or not. The final test would be thermoregulatory sweat test. This is a test where a specific moisture-sensitive powder is spread throughout the skin. When the excessive sweating is triggered at room temperature, the powder changes color. This is where the doctor determines its severity.

What Are The Treatments?

Some treatment related to changes in daily activities and lifestyle may help alleviate the sweating and improve the symptoms such as putting on antiperspirants, armpit shields, or wearing synthetic clothing or shoes. If the hyperhidrosis doesn’t lessen at all, a doctor may recommend to see a dermatologist, a skin specialist, who will advise either of the following:
1) Botox injections – these injections block the nerves that trigger sweat glands
2) Iontophoresis – a treatment where both the hands and feet are submerged in a bowl of water and electric current is passed.
3) Anticholinergic drugs – these drugs inhibit the transmission of parasympathetic nerve impulses.

If all of the treatments mentioned above cannot solve the problem, the dermatologist would have to recommend a surgery called Endoscopic Thoracic Sympathectomy, otherwise known as ETS.

What is ETS?

ETS is a surgery that is involved with cutting the sympathetic nerve, which controls the sweat action. ETS requires general anesthesia, while the procedure takes less than an hour to complete. Once the patient is asleep, the surgeon performs two or three small incisions below the armpit. This is performed using VATS, or Video-Assisted Thoracopscopic Surgery. Through VATS, the doctor can locate the sympathetic chain, and isolate it with precision. Once the doctor isolates it, he or she then performs a cut in the nerve depending on the type of hyperhidrosis you have. If it’s palmar hyperhidrosis, the cut is somewhere in Ribs 3 or 4. For axillary hyperhidrosis, it is cut in Ribs 4 or 5. For facial hyperhidrosis, the cut is made in Rib 3. After the procedure, the patient stays in the hospital for a few hours following surgery. Oral medication is then given to the patient. There are those who are reported to have experienced mild post-operation discomfort that can last between 7 to 10 days. ETS has a 90% success rate with very few side effects and low failure rate.

What Are The Side Effects of ETS?

One of the most common side effects of ETS is what the doctors call compensatory hyperhidrosis. This happens when the patient has excessive sweating in other areas of the body, such as back, chest, or legs. This side effect is common, mild, and manageable compared to what they have experience before.

If you are experiencing any symptoms related to hyperhidrosis, it is best to seek medical attention as soon as possible. This will not only help deal with the problem, but at the same time, make you more comfortable than ever when it comes to social interactions.

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