Sweating is one of the ways we regulate our body temperature, it also helps to keep our skin moist and helps with grip. Sweat is produced by thousands of little glands in the skin. These glands are controlled by the sympathetic nervous system.
Many people suffer from occasional episodes of excessive sweating, particularly when anxious or under stress and many can be managed with simple measures such as strong antiperspirants. However, in some people (about 1% of the population), the nervous system is overactive and causes sweating to occur in specific places in the body, often at inappropriate times.
Excessive sweating most often affects the hands and armpits. This can be a serious problem causing social embarrassment and difficulty with practical tasks such as holding a pen. Before considering surgical treatment it is sensible to have tried simple measures such as strong antiperspirants and to be clear that there is a major problem that is persisting despite them.
Axillary (armpit) hyperhidrosis is effectively treated with botox injections. Botox blocks the nerve signals to the sweat glands, stopping the sympathetic nerves from working. The effect is temporary but usually lasts about six months. The treatment can be performed in an outpatient setting and can be repeated as required.
Palmar (hand) hyperhidrosis is most effectively treated with keyhole surgery. Thoracoscopic sympathectomy involves cutting the sympathetic nerves that control the sweat glands of the hand and armpits which run inside the rib cage. The operation is performed through one or two small incisions beneath the armpit. The procedure is done under general anaesthetic as a daycase or with an overnight stay. As a side effect of the procedure patients may notice increased sweating in other areas, notably the back or chest, this is called compensatory hyperhidrosis. Surgery has a high success rate. Complications are rare, however, your surgeon will discuss potential complications with you in advance of the procedure.