Medical Q&As

Hyperhidrosis - surgery?

I suffer from hyperhidrosis and my GP has recommended surgery. Are there any side effects?

Hyperhidrosis means excessive sweating and this can be a cause of considerable embarrassment. It principally affects the hands and armpits. Surgery involves the resection of the ganglia or nerve bundles that control the sweat glands in the upper limb. The ganglia that are removed are known as the sympathetic ganglia and the specific ones that are removed are at the level of T2 and T3. T2 and T3 refer to the second and third thoracic vertebrae, which are the upper vertebrae in the thoracic or chest portion of the spine. The relevant ganglia are located at either side of each of these upper thoracic vertebrae. The principal side effect that can occur is compensatory sweating, which means that there may be an increase in sweating from other areas of the body in order to compensate for the lack of sweating from the hands or armpits. In practice this tends to be a negligible side effect because the compensatory sweating is spread over a larger surface area of the body and not confined to a small area such as the palms of the hands. Sympathectomy provides permanent relief from this complaint. Some doctors now treat the condition with injections of botulinum toxin, which is also known by the proprietary name of Botox. However, this technique may need to be repeated on separate occasions over time since its effects may not be permanent.