An increased sweat production often leads to physical as well as psychological distress, and when deodorants or other products don't seem to fix the problem, surgery can be a solution.
Generally about the treatment
Sweat has the purpose of cooling down the body, and for that reason it is usually a positive and natural system to get rid of excess body heat.
There are those, however, who produce too much sweat. Hyperhidrosis is a condition in which the sweat glands produce excess sweat, usually in the palms, under the arms, or underneath the feet. The condition is incurable, and can have a devastating effect to a person's confidence, social life, and physical well-being.
The consumer market offers a variety of anti-perspirants, supplements and other similar products that are meant to help reduce the sweat production (such as Botox / Dysport for Excessive Arm Sweat), but these treatments aren't always effective enough, and none of them are permanent. If nothing else seems to be working, surgery can be the right solution.
Suitability
Fit and healthy men and women, over the age of 18, that have failed to find a solution to their problem with excess sweat through less invasive measures than surgery.
The procedure
The 2 most commonly used operations are the so-called ETS (Endoscopic Transthoracic Symathectomy) and the more frequently used; Axillary Suction Curettage operation.
Axillary Suction Curettage
Axillary Suction Curettage (scraping/suctioning of fat glands from the armpit) is the most frequently used method, as it is less invasive and has fewer side effects and risks. As the name implies, this procedure involves suctioning and scraping out the majority of the sweat glands.
The surgeon will insert a few tiny cannulas through tiny incisions, made to the skin by the armpit. These cannulas will remove 90-95% of the sweat glands through small zig-zag motions. Special scrapping instruments are used to remove the glands.
Axillary Suction Curettage is a relatively simple operation, and usually takes about an hour to perform.
ETS
For the ETS operation, the surgeon will make a few incisions, after which he or she will insufflate air into the chest cavity, in order to temporarily push away the lung. The surgeon will then insert endoscopic instruments into the armpit, and with the help of these he/she will locate and remove the connection between the nerves and the sweat glands, in order to prevent the sweat from appearing in the troubled area.
The majority of patients, who have this type of surgery performed, will experience that the sweat will develop in a different area on the body instead, which can be just as frustrating as their previous condition.
Anaesthesia
The Axillary Suction Curettage operation will usually be carried out under local anaesthesia.
The ETS operation can be done under local or general anaesthesia.
Side-effects
Approximately 70 % of patients, who undergo an ETS operation, will experience that the sweat production is moved to a different area. To some this may feel more manageable than before, whereas others will feel just as plagued by the relocated problem.
Some patients may experience that the skin on their face becomes very dry, which can then lead to acne.
Axillary Suction Curettage does not have any known side effects. As an advantage of this surgery 5-10 % of the sweat glands will prevail, which can help prevent the skin from drying out.
Risk of complications
The risks of an ETS operation are:
Horner's syndrome (sagging eyelids, lack of facial sweat). This has only occurred in 0.3 % of cases, and is more commonly seen for surgery for excessive facial sweating.
There is a risk of developing a gustatory sweat tendency in the face (a tendency for facial sweat to occur through smelling food, or while eating). This is, however, also very rare.
There is a risk of developing temporary back pains.
There is a risk of a decrease in the heart rhythm by 10 %. There is, however, nothing to indicate that people, who are regularly active, should suffer from this.
With the Axillary Suction Curettage operation there is a risk of tissue formation, which can be treated.
There is a risk of side effects from the anaesthetic used, along with bleeding, poor wound healing, a poor cosmetic result, and blood accumulation.
No form of surgery is risk free, although severe complications are very rare.
Healing and recovery
Most patients can return to work and normal activities a few days after surgery. Those, who undergo an ETS operation are likely to experience a more painful recovery period than those, who have undergone the Axillary curettage operation.
Duration of the result
As previously mentioned, the ETS operation may cause the excess sweating to relocate, so even if the armpits are permanently sweat-free the patient may still be left with a disappointing result.
The Axillary Curetage operation is relatively permanent. There have been a few cases where the problem has returned, though.