Excessive sweating can be a real nuisance – in severe cases it can ruin people’s lives by causing social embarrassment. Most patients are young adults and the problem is three times more likely in women than in men, the most common areas affected are the armpits, hands, feet, face and scalp and occasionally in the groin, on the back or between the buttocks.

Excessive sweating in the hands can cause social problems in holding hands or other physical contact; patients may have trouble holding pens and problems using keyboards.

Many people are profoundly embarrassed by excessive perspiration especially those with uncontrolled facial sweating. Many of patients have sought medical help without success which may lead to feelings of rejection or inadequacy.

For further information regarding the causes of this condition, Excessive Sweating Tips is a resource conceived by a London cosmetic clinic, created specifically to enable sufferers of this disorder manage their symptoms through thoroughly examining the factors which contribute.

Non-operative Treatments

Antiperspirants – There are very strong anti-perspirants available containing aluminium hydroxide which can be helpful although they are irritants and make the skin very dry.

Drug treatments – Some drugs can reduce sweating but these medications can have bad side effects such as blurred vision and dry mouth so a lot of patients do not like to take them.

Counselling – If certain stressful situations provoke an attack of excessive sweating this can cause a ‘vicious cycle’ of anxiety, some patients find that counselling (psychotherapy) can be very helpful in overcoming their issues and reducing perspiration. Some patients also find hypnosis helpful.

Iontophoresis – This is a treatment for the hands and feet where the affected part is placed in a water bath and a mild electric current is passed through the water, it is not known why this works to reduce excessive sweating. It is not ideal for hand sweating as there are other very effective options for this such as thoracoscopic sympathectomy (see operative treatmeants) but it can be a useful option for sweaty feet. The treatment does need to be repeated frequently.

Botox injections – Botulinum toxin (botox) is the same drug  used to improve facial wrinkles and injected into the armpit can be very effective in reducing sweating. The injections are made with a very fine needle and the whole procedure takes about 15-20 minutes and avoids an operation. The drawback is that the treatment needs to be repeated at 4-6 monthly intervals.

Operative Treatments

Thoracoscopic Sympathectomy

For patients suffering from sweaty hands, the best option is probably an operation
called endoscopic transthoracic symathectomy (ETS). It is a key-hole surgery operation that is 99% effective at curing hand sweating and, with a slight modification, can also cure armpit sweating in 70-80% of people. The same operation can also be used for facial flushing, blushing or sweating – although it is less successful for this problem.

ETS is done to divide the nerves which run in the back of the chest wall. To do the operation, the patient is given a general anaesthetic and a surgical telescope is inserted into the chest through a tiny (1cm) incision. The scars are tiny and can barely be seen after only a few weeks.

The nerve chain can be seen and cut. By doing this, the hand instantly becomes bone dry as the nerve signals to the sweat glands are switched off. If the armpit is being treated as well, removal of another part of the chain can stop the sweating in four out of five cases.

Will my medical insurance cover sympathectomy?

Most insurance companies accept claims for this type of surgery but as always it is important to check on your particular cover before going ahead.

Side Effects

As with all surgical procedures there are side effects and potential complications that patients and their relatives must be aware of before having this operation.

Compensatory sweating – Sometimes after the operation, the sweat that should have come from these areas is re-distributed elsewhere in the body. This is called Compensatory Sweating. It can be especially bad in the lower back.

Damage to the lung needing a chest drain – In rare cases (approximately 1 in 100 patients) the lung can be difficult to re-inflate after surgery. It is then necessary to insert a small tube into the chest (called a chest drain) for a couple of days to get the lung expanded again.

Horner’s syndrome – If higher parts of the sympathetic chain are injured during surgery the face can become dry on the same side as the operation and the eye lid may droop a little. This is called Horner’s syndrome. This problem is rare and usually temporary.