Perspiration is the body's natural method of cooling itself down during active periods or exposure to warm conditions. Severe hand sweating, underarm perspiration, facial sweating and uncontrollable rapid facial blushing with a feeling of embarrassment is usually caused by an increased activity in the sympathetic nervous system a system of nerves over which we have no control. Such excessive perspiration and/or blushing is not important for normal regulation and control of body temperature. These conditions can be cured by dividing or clamping the nerves which regulate sweating of the hands, armpit and face as well as facial blushing. The surgical cure for this affliction is known as ETS or Endoscopic Transthoracic Sympathectomy. An experienced surgeon will locate the specialized area of the nervous system inside the chest cavity. Using a miniature camera and instruments, the nerve supply to the sweat glands is cut or clamped, preventing excessive sweating and/or blushing. Excessive sweating involving the whole body or constant redness of the face is not suited for surgical treatment.

 

Should be considered before deciding to undergo surgery since the ETS procedure is irreversible. Nonsurgical options for excessive sweating include:

• Topical Astringents (Drysol, Maxim - www.coradhealthcare.com) which shrink the sweat glands
• Botox (Botulinum toxin A) injections into the affected areas of the skin
• Biofeedback
• Acupuncture
• Anticholinergic medication such as Glycopyrrolate or Homocyamine can reduce sweating but can cause dryness over the entire body
• Medication such as betablockers and serotonin uptake inhibitors may reduce facial blushing
• Stellate Nerve Blocks temporarily work and
• Iontophoresis (electrical saltwater baths applied to the affected area) see www.Drionic.com The decision to undergo surgery depends on the level of distress suffered by the patient, not the amount of sweating and blushing that occurs.

The expected effects of the procedure must be weighed against the risks, complications and side effects. Previous surgery of the chest and obesity will reduce the chance for a successful operation and increase the risk for complications.