Thoracic Surgery

Hyperhidrosis / Excessive Sweating

You may find that you sweat a lot. All the time. You may find that you don’t feel comfortable doing things other people take for granted, such as wearing nice clothes, shaking hands, or even gripping objects. Doctors call this condition hyperhidrosis. It affects approximately 7.8 million people in the United States. It commonly occurs in young adults, but may develop as early as childhood and persist throughout adult life.

At Mount Sinai, we can help. We perform a procedure called bilateral endoscopic transthoracic sympathectomy (ETS). We make two small incisions in your chest. Then we cut the sympathetic nerves at precise locations on each side of the chest. You will notice an immediate and dramatic reduction of sweating—and a significant improvement in your quality of life.

About Hyperhidrosis

You may find you start to experience excessive sweating during puberty. Many hyperhidrosis patients have a family history of this condition. It affects more women than men.

Hands and underarms are the parts of the body that tend to sweat excessively. About one in four hyperhidrosis patients have sweaty hands, one in five have sweaty armpits and more than half experience both issues. Approximately 45 percent of patients have sweaty feet. Sweating can be triggered by emotional or stressful situations. We make every effort to identify the underlying cause of hyperhidrosis before beginning treatment. You can have hyperhidrosis on one side of your body or on both (called bilateral).

Sometimes hyperhidrosis is the main condition (primary) you are experiencing. Sometimes it is a side effect of another condition (secondary). Doctors do not know what causes primary hyperhidrosis. It is not very common, affecting about one percent of the population. Secondary hyperhidrosis can arise due to medical conditions such as:

  • Focal lesions of central nervous system
  • Hyperthyroidism
  • Hypoglycemia
  • Menopause
  • Neurological disorders
  • Use of antidepressants

Treatments We Offer

We use medications and surgical procedures to treat hyperhidrosis.

Medications include:

  • Prescription antiperspirant: May contain aluminum chloride, which can irritate you skin and eyes. You can use hydrocortisone cream to help with the irritation.
  • Prescription creams: Containing glycopyrrolate, these help hyperhidrosis on the face and head.
  • Nerve-blocking medications: Block the chemicals that allow certain nerves connections. You may experience dry mouth, blurred vision, and bladder problems.
  • Antidepressants: These pills can decrease sweating as well as the anxiety that makes you sweat more.
  • Botulinum toxin (Botox) injections: Block the nerves that cause sweating. We ice or anesthetize your skin first, then provide several injections for each part of your body that sweats excessively. The effects last between six and twelve months. Side effects can include temporary muscle weakness.

Other procedures include:

  • Microwave therapy: Delivering microwave energy to your sweat glands in two, half-hour sessions. Side effects can include a change in skin sensation and discomfort.
  • Sweat gland removal: Remove the sweat glands from the armpits using a minimally invasive technique called suction curettage.
  • Nerve surgery (sympathectomy): Under general anesthesia, we make two small incisions in your armpit. We insert a small telescope attached to a camera and a dissection device into the chest cavity. Next, we cut the sympathetic nerves on both sides of your body. After this procedure, you may experience chest and incision site discomfort for two or three days. You should be able to return to your daily routine after a week.