What is Hyperhidrosis Surgery?

Hyperhidrosis is generalized, or localized, excessive sweating. Areas that are commonly affected are the palms of the hands, soles of the feet, armpits, and forehead. The sufferer may also experience excessive blushing along with sweating. Hyperhidrosis surgery is a procedure that seeks to permanently remedy the problem of excessive sweating by blocking the nerves that send signals to the sweat glands.

Sweating is a biological response that is initiated when the body is too warm, under extreme emotions like anxiety and fear, with exertion, and due to illness. Sweat glands are located under the skin all over the body, but they happen to be quite numerous in areas like the palms, bottom of the feet, forehead, and armpits. The sweat glands are controlled by the sympathetic nervous system, which is responsible for fight or flight responses in the body. This system of nerves can become overactive and cause some people to sweat excessively.

Excessive sweating often begins during childhood and progressively gets worse as the patient enters adulthood. It is estimated that 1% of all adults suffer from hyperhidrosis. A patient who suffers from excessive sweating should visit a doctor to rule out any other underlying biological causes. Prescription powders and creams may be given to attempt to control the problem. Patients can opt for hyperhidrosis surgery as a permanent option.

There are two types of hyperhidrosis surgeries, ganglianectomy and sympathectomy. Ganglianectomy hyperhidrosis surgery is the most widely used to cure excessive sweating. A surgeon makes a .4 inch (1 cm) incision under each armpit and severs the problematic nerves. These are known as the third and fourth ganglia — a ganglia in this case is a large bundle of sympathetic nerves. The doctor can surgically alter these because they affect the armpit sweat glands, and the sympathetic nerve chain that also controls blushing and foot, hand, and facial sweating.

After such surgery, a patient may experience compensatory sweating as a side effect. This means that the nervous system may send signals to the other sweat glands in the body, like the ones on the inner thighs, to compensate for the sweat glands that were rendered inactive. As a result these areas will noticeably sweat more. It is estimated that anywhere from 5% to 20% of patients who undergo hyperhidrosis surgery will experience compensatory sweating. About 7% of the patients who experience compensatory sweating will suffer from an extreme form of it, but, in most cases, this disappears with time.

Sympathectomy hyperhidrosis surgery is less invasive than ganglianectomy hyperhidrosis surgery. To perform this procedure, a surgeon makes a small incision in each armpit, but instead of severing the nerves, he places a .197 inch (5 mm) clip on each nerve, or nerve bundle, that controls the problem area. These clips block nerve impulses to the sweat glands. This procedure is reversible so, if a patient experiences severe compensatory sweating that does not dissipate, the doctor can remove them to restore proper nerve function.