Surgical options in treating hyperhidrosis (excessive sweating)

The surgical options in treating hyperhidrosis. These are usually for treating patients who have hyperhidrosis affecting the hands, the armpit or the face or the soles of the foot. With respect to the armpit, it is possible to offer people an operation using either laser or open surgery where you damage the sweat glands to prevent sweating. However the most well-established surgical way of treating people who have sweating in the upper limbs or potentially in the feet is to use a technique called sympathectomy. In the upper limbs this is usually done thoroscopically and is called endoscopic thoroscopic sympathectomy. This involves putting a tube into the chest identifying the sympathetic nerves in the chest and dividing these to prevent the area that those nerves supply from sweating. This technique works very well however it is associated with various potential complications. One there is obviously the complication of a major operation and having tubes put into your chest. Two, if the nerves are divided too highly in the chest, this can cause something called Horner's syndrome where the eyelids will lag and the pupil will dilate and this is something called Horner's syndrome. But the third and probably the issue that is the most troublesome for people who undergo an operation is something called compensatory sweating. This can occur in anything up to 40% of patients, however severe compensatory sweating probably only occurs in about 2-5% of patients but is a significant problem and does need to be considered before you think of a surgical intervention. However I would give you anecdotal evidence that I have had patients who are architects have gone back to architecture because they no longer smudge their drawings. I can also give you an example of somebody who for the first time was able to hold their partner's hand the first time at their wedding when she was able to walk down the aisle holding their hand. So appropriate treatment can actually revolutionise the quality of life that patients with hyperhidrosis have. The key thing is to see an expert and discuss the pros and cons of intervention. Thank you very much.