Surgery Questions

There are basically two types of surgery both of which are usually done for armpit sweating. One type is very local and treats the sweat glands directly the other involves surgery to the nerves a little further away in the region that supply the sweat glands.

Using either traditional surgery or a laser the sweat glands under the arms can be removed or deliberately injured to stop them working. The terms ablation, curettage or excision might be used by the doctor. Some doctors undertake liposuction to remove the fat layer beneath the skin where the sweat glands are. Sometimes combinations of techniques are used. Most procedures can be performed with a local anaesthetic.

In common with most surgery you could expect some pain, swelling and bruising afterwards. There may be scarring or loss of sensation in the area and occasionally it could get infected. Compensatory sweating (sweating in another part of the body) is not usually seen after localised procedures unlike ETS surgery. 

ETS stands for Endoscopic Transthoracic Sympathectomy. This type of surgery is generally considered to be a last resort for the treatment of hyperhidrosis and is not commonly undertaken these days in the UK. It involves using a camera (endoscope) going through the skin, collapsing the lung and getting to the nerves near the spine that supply the sweat glands. The nerves are then cut or clamped to stop them working. The procedure is permanent and cannot be reversed.

Whilst the surgery is generally effective in reducing sweating of the hands and/or armpits it is major surgery and carries risks. The major side effect is that the majority of patients experience compensatory sweating of another part of the body which is extremely difficult to control.

Sometimes the compensatory sweating can develop some years after the surgery.