Several treatment options are available for primary hyperhidrosis. Your doctor will work with you to find the least invasive treatment that relieves symptoms.
Medical treatments may include:
Surgery is generally reserved for severe cases of hyperhidrosis in which other treatments have been unsuccessful. At Mayo Clinic, surgery is generally highly successful in treating palm (palmar) and underarm (axillary) hyperhidrosis, but much less successful in treating foot (plantar) hyperhidrosis. Mayo doctors don't advise surgery if only your feet are affected.
There are three main approaches to surgery:
Sympathectomy. This surgery, available for more than 70 years, involves interrupting the nerve signals to the skin. In the minimally invasive version done today, the surgeon either uses clips on the sympathetic nerve to block nerve impulses or cuts or burns the affected area of the nerve. The procedure is better for stopping excessive sweating on your palms than on your underarms and feet. Rarely, people develop excessive new sweating elsewhere on the body (compensatory sweating) as a side effect. The advantage of clipping is that, if compensatory sweating occurs within a month of the surgery, surgeons can reverse the procedure by removing the clips.
The traditional form of sympathectomy, also called a ganglionectomy, is not reversible. It involves removing most or all of the upper thoracic sympathetic nerve chain. A common complication of this surgery is compensatory sweating, in which people experience new excessive sweating elsewhere that can be as much of a problem as the original symptoms. Mayo Clinic doctors do not recommend traditional sympathectomy.
Sympathotomy. This surgery, called endoscopic transthoracic sympathotomy, is a relatively new procedure developed and pioneered at Mayo Clinic. It interrupts the nerve signals without removing the sympathetic nerve and controls hyperhidrosis without causing compensatory sweating. This procedure is performed at Mayo Clinic in Minnesota and Florida.
In a sympathotomy, the surgeon disconnects two clusters of nerve cells (ganglions) on the sympathetic nerve, blocking the nerve pathway that causes excessive sweating. More than 120 people have had this surgery with excellent results, which included relief of palmar hyperhidrosis and some improvement in plantar hyperhidrosis. After surgery, no one has had severe compensatory hyperhidrosis at average room temperatures; two people have had it during exercise or working in hot conditions.
Like all surgeries, surgery for hyperhidrosis carries some risks:
Read more about treatment of hyperhidrosis.
Mayo Clinic surgeons describe hyperhidosis surgical options on YouTube:
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