The human body sweats to maintain its temperature at a normal level. This process is regulated through the Sympathetic Nervous System, which controls approximately 5 million sweat glands in the body.
The branches of the Sympathetic Chain that control sweating are located inside the chest cavity.
Excessive sweating (Hyperhidrosis) is a condition where the body sweats more than necessary.
You are about to attend a job interview or meet someone new. Suddenly, you feel excessive sweating in your hands and underarms. Or, after completing your workout, you notice that your body is excessively sweating. Your body normally secretes sweat to cool itself. This is a normal situation.
However, in approximately 2% of people, this sweating condition occurs not due to hot weather, excitement, or physical exertion but can happen at any time of the day and in any season, except during sleep. This condition is known as Localized Excessive Sweating – Hyperhidrosis.
Areas Affected by Excessive Sweating
Excessive sweating occurs either suddenly or persistently in four areas of the body:
- Hands,
- Underarms,
- Feet,
- Face and Scalp.
Symptoms of Excessive Sweating
Excessive sweating in the hands, feet, underarms, or face is a profound and dramatic experience for the patient. It affects all aspects of life, including professional activities, daily routines, and interpersonal social relationships.
Hand Sweating
Hand sweating can occur due to nervousness or emotional stress during an initial meeting with someone. A light wiping can eliminate this sweat. However, in cases of severe hand sweating, visible drops of sweat can be observed dripping from the hands. This condition can be seen even during childhood.
Patients with excessive hand sweating are constantly aware of this condition and believe they have to live with it. Often, hand sweating is the most distressing symptom of excessive sweating. Many patients also report that their hands feel cold and clammy.
Since hands are always visible in social and professional settings, many patients with excessive sweating avoid social interactions and remain constantly alert. They try to avoid handshakes or paperwork. Patients even feel uncomfortable holding their loved ones’ hands.
Underarm Excessive Sweating: This condition causes uncomfortable sweat stains on underarm clothing. As a result, people tend to avoid fabrics or colors that show sweat when choosing clothes.
Foot Sweating
This condition leads to foot odor. Additionally, when hand and foot sweating occur together, driving becomes more challenging.
Facial Sweating
Facial sweating causes individuals to appear excessively nervous and insecure, even when they are not. Along with facial sweating, another disturbing condition known as excessive blushing may also occur.
Treatment Methods for Excessive Sweating
Initially, antiperspirants and creams are used.
Although anticholinergic medications can sometimes be effective, they may cause side effects such as dry mouth, blurred vision, constipation, and palpitations as they affect the entire body.
Additionally, botox injections or methods known as iontophoresis are also used.
Botox applications are suitable for underarms. However, practical use of botox for hands, feet, and face is extremely difficult and painful. These injections must be repeated 2 or 3 times a year.
The U.S. Food and Drug Administration (FDA) approves the use of botox for excessive sweating treatment only for underarms. It does not permit its use for hands and feet!
Is There a Permanent Treatment for Localized Excessive Sweating (Hyperhidrosis)?
Yes, the only long-term and effective treatment for excessive sweating is surgically interrupting the transmission of sympathetic nerve signals to the sweat glands.
Simply put, this procedure results in the treatment of all areas affected by excessive sweating (hands, feet, underarms, and face). This procedure is known as Endoscopic Thoracoscopic Sympathectomy (ETS).
ETS Procedure for Localized Excessive Sweating
- Endoscopic Thoracoscopic Sympathectomy (ETS) is performed by an experienced thoracic surgeon with only a 1-day hospital stay. The procedure is completed under general anesthesia by placing titanium clips on the sympathetic chain near the back of the ribs inside the chest cavity with the help of a camera.
- This procedure takes approximately 1 hour for both chest cavities.
- Patients can return to work about 3 days after the procedure.
- This method is highly effective for hand and underarm excessive sweating.
Post-Surgery Images of Patients Treated with Single-Port ETS
Results of Excessive Sweating Treatment
Nearly 100% improvement in symptoms is achieved immediately after the operation. In the long term, 85% of patients experience a significant reduction in hand sweating. Complete recovery from underarm sweating is observed in 70% of patients in the later stages.
Side Effects of Single-Port ETS
The most common side effect is increased sweating in other areas of the body (abdomen, back, waist, or legs). However, severe problems are observed in only 1% of patients.
Additionally, a rare and temporary condition known as Horner’s Syndrome, which involves drooping eyelids and blurred vision, may occur (3%). A 10% reduction in heart rate and the presence of air in the chest cavity are other rare complications.
In experienced centers performing the procedure, the likelihood of these conditions occurring is much lower.
Post-Surgery Patient Satisfaction Rates
A scientific study conducted in Dallas, Texas, on 170 patients reported the following satisfaction rates one year after the procedure (source: Dewey et al: Ann Thorac Surg 2006:81:1227-33).
| Very Satisfied: 93.3% |
| Satisfied: 5% |
| Not Satisfied: 1.7% |
