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Medical Edge Newspaper Column from Mayo Clinic
EXCESSIVE SWEATING: SURGERY CAN BE A TRADEOFF
DEAR MAYO CLINIC: I am an executive whose professional life depends
on poised performance in social situations, but I’m being compromised
by untimely and embarrassing episodes of excessive sweating. My physician
is currently treating this “hyperhidrosis” with prescription medication.
But I really think that mine might be a case where surgery is the answer.
Please give me some guidance on surgery for hyperhidrosis. — Sheboygan,
Wis.
ANSWER: Because stress or anxiety can trigger episodes of hyperhidrosis,
anti-anxiety medications can sometimes provide relief. Topical creams,
such as the drug Drysol, may also help. An overactive thyroid gland can
cause excessive sweating as well, so thyroid function should be tested
as part of the evaluation for hyperhidrosis.
But as you suggest, surgery has proven effective for treating some forms
of hyperhidrosis. Typically, a procedure called “endoscopic transthoracic
sympathectomy,” or ETS, severs the nerves that send signals to the sweat
glands in parts of the body — such as the hands or face — that experience
profuse sweating.
A small incision is made near the armpit, and a tube with a tiny video
camera at its end is inserted so that the surgeon may visually locate
the target nerves. The ETS procedure, done under general anesthesia, can
be performed on an outpatient basis, though it may require 12 to 24 hours
of hospitalization. Recovery time is typically seven to 10 days.
The success rate for ETS varies with the part of the body affected by
excessive sweating. Palmar hyperhidrosis, or the sweating of the palms,
has the highest success rate, with 95 to 98 percent of patients cured
following surgery.
It is important to note, however, that most people who undergo ETS soon
develop “compensatory” hyperhidrosis, or increased sweating in other parts
of the body not originally affected by the disorder. For example, you
might notice marked improvement in palmar hyperhidrosis after ETS but
may sweat more on the back, chest or legs.
Some patients who have had ETS for facial sweating also report unpleasant
side effects, such as hot flashes, increased facial-skin sensitivity or
dryness, and fatigue. Be sure to discuss these potential problems with
your doctor.
Although surgery has successfully cured many cases of hyperhidrosis, it
should be undertaken with an awareness of the risk of such unpleasant
side effects, and only after other treatment options have proven unsuccessful.
— Mark Allen, M.D., Thoracic Surgery, Mayo Clinic, Rochester, Minn.
Additional Resources:
Hyperhidrosis
Appointment
Information
More Information
on Hyperhidrosis
READERS: Boys in general, and both boys and girls born to parents
who have lower education levels (12 years or less), were found in a recent
study to be at a greater risk for developing attention-deficit/hyperactivity
disorder. It is a learning disability that affects about 7.5 percent of
youths by age 19. Symptoms of AD/HD include a diminished attention span,
increased level of hyperactivity and low impulse control.
The study showed that when parents had 15 years or more of education,
the association between AD/HD was not as strong as it was with lower levels
of parental education. These findings on possible risk factors for development
of AD/HD may help doctors and school officials identify children with
increased risk of AD/HD, and assist the children with their disorder at
an earlier age.
Additional Resources:
AD/HD
Appointment
Information
More Information
on AD/HD
- - -
Medical Edge from Mayo Clinic is an educational resource and doesn’t replace
regular medical care. To e-mail a question, go to www.mayoclinic.org,
or write: Medical Edge from Mayo Clinic, c/o TMS, 2225 Kenmore Ave., Suite
114, Buffalo, N.Y., 14207. For health information, visit www.mayoclinic.com.
© 2005 TRIBUNE MEDIA SERVICES, INC.
- - -
Medical Edge from Mayo Clinic is an educational resource and doesn’t
replace regular medical care. To e-mail a question, go to www.mayoclinic.org,
or write: Medical Edge from Mayo Clinic, c/o TMS, 2225 Kenmore Ave., Suite
114, Buffalo, N.Y., 14207. For health information, visit www.mayoclinic.com.
© 2004 TRIBUNE MEDIA SERVICES, INC.
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