Hyperhidrosis is a condition where there is profuse and excessive sweating of the head, underarms, hands and/or feet. Normally, the body maintains a steady core temperature and sweating is a natural mechanism used to dissipate heat. Individuals with hyperhydrosis have sweating well in excess of what is considered normal and frequently are affected by serious social problems, i.e. unwillingness to shake hands or to give public talks.
Hyperhidrosis usually begins in a person’s teenage years and is the result of an overactive sympathetic nervous system. The body’s central nervous system has various trunks and branches, one of which is called the sympathetic nerve trunk. Here, long chains of nerves lie alongside the spinal cord and originate from three different areas– cervical, thoracic and lumbar regions. The nerves affecting hyperhydrosis are located in the thoracic part.
There are a number of ways to treat hyperhidrosis including prescription deodorant, talc and creams, Iontophoresis (the use of water and electrical current to reduce sweating) and oral medications. For patients whose symptoms that do not respond to these treatment options, a surgical intervention called a thoracic sympathectomy is available.
Thoracic sympathectomy is performed on an outpatient basis and requires one or two small incisions on either side of the chest, under the armpit. During the operation, the surgeon will either cut or clip the nerves that supply the sweat glands in the skin, decreasing the production of sweat. Thoracic sympathectomy is not the answer to all problems as over 80% of patients can developed a side effect of the operation called compensatory sweating, which is an increase in sweat production in other areas of the body. In general these symptoms are mild and overall patient satisfaction after the operation is very high.