Have you been blushing without reason throughout your life? Do you sweat more than others? Are you increasingly bothered by the stains under your armpits? Are you feeling self conscious when shaking hands because of wet palms? A simple surgical procedure can make excess reddening or sweating in certain parts of the body a thing of the past.

Patients suffering from hyperhidrosis have a life long problem with excessive sweating in parts of their bodies. The condition most often arises in puberty but can in some cases arise later in life. If excessive sweating during puberty can be blamed on hormone changes, the reasons for excessive sweating of healthy persons who experience the condition in childhood or after puberty is unclear. Most, however, are bothered by it. If sweat drips from your palms or face throughout the year regardless of stress levels and you hesitate to wear colored or sensitive garments because you know sweat stains under your armpits will ruin your image, you are most likely faced with emotional distress and troubles in your social, professional and intimate life. Similar problems are also experienced by those who blush excessively. In many cases such people limit their contacts with others to the least possible degree due to shame. It is even more difficult for those that give up their life’s ambitions because of their condition, avoid certain occupations or social events. Some voluntarily isolate themselves from society or even attempt suicide. The potential psychological consequences of excessive sweating or reddening can be very serious and should not be underestimated.

Blushing and sweating
If sweat drips from your palms or face throughout the year regardless of stress levels, you are most likely faced with emotional distress in your social, professional and intimate life. 


Methods of treatment

The most safe and effective course of treatment is video thoracoscopic sympathectomy of the upper sympathetic ganglia. It is used to stop both excessive sweating and blushing.

Pharmacists can recommend various antiperspirant products such as creams, powders and others, which do partially limit sweating in certain parts of the body. Psychiatrists and family physicians may believe the issues are due to psychological stress and prescribe sedatives or walks in nature. There are also other treatment options: the first is an application of botulinum toxin injections, one per each square centimetre of skin. The procedure is quite painful since palms, feet and armpits have plenty of nerve endings, and needs to be repeated in a few months because its effects are only temporary. The second possible treatment for excessive sweating under the arms is performed by plastic surgeons and includes the removal of parts of skin including subcutaneous tissue and sweat glands. This reduces the surface area that produces sweat, but its effects are limited as sweat glands may regrow. It also leaves scar tissue.

If you have tried every other method without success, perhaps consider a surgical solution. It will change your life for the better.

Effective surgical treatment - video thoracoscopic sympathectomy

Excessive sweating and blushing are a consequence of excessive functioning of the sympathetic nervous system. The solution is to surgically prevent impulses from travelling to nerves responsible for blushing or sweating of certain body parts. Sympathetic nerves are situated over the ribs and along the spine on both sides of the body. The appropriate ganglion for the patient’s problematic body area is clamped with a metal clamp to stop impulses travelling to the nerves. The procedure is performed under general anaesthesia with intubation, whereby the tube has two openings to allow air to pass to each lung separately. The operating surgeon uses a camera and surgical instrument inserted trough centimetre-wide incisions under both armpits. Using the video camera the surgeon is able to accurately gauge the position of the appropriate ganglion, avoiding any undue complications.

Potential complications

Although no problems have occurred in practice so far, every surgical procedure carries a certain risk of complications. Minor issues may arise upon clamping of the ganglion, leading to injuries of the surrounding tissue and potential bleeding. Any bleeding is most likely small, but if large scale bleeding occurs, the surgeon must open the chest and take appropriate action. Greater complications can occur if the patient’s lung is attached to the chest wall, reducing space for manipulation. If the lung is completely attached to the wall, the chest must be opened by about ten centimetres and the connective tissue must be cut through, causing the patient pain in the post-operative period, but no such procedure has been required so far.

Potential complications after the procedure/h4>

The most common complication after the procedure is the occurrence of sweating in another area, which the surgeon cannot foretell. Data from expert literature: experts estimate that sweating occurs in other areas in 5 to 45 percent of patients, but the classification is unclear; it may include those who are bothered by such sweating as much as before the procedure or all patients who experience any sweating at all. The number could perhaps be higher if we consider all of the above.  Areas of the body where such sweating occurs include the amdomen, back or thighs, but most patients find it less irritating or stressful than beads of sweat under the arms, on the palms or face.

New sweating hotspots may include the abdomen, back or thighs.

Another potential complication can occur during procedures to prevent blushing or sweating on the face. A surgeon may make a miscount the ribs and place a clamp on the stellate ganglion in the vicinity of the first rib. This does achieve the desired effect and prevents blushing or sweating, but it brings unwanted consequences such as constricted pupils or drooping eyelids. Such complications are extremely rare and can in fact be remedied. In such cases a surgeon can remove the clamp from the ganglion and place it on another. The ganglion renews itself in time and the issues pass. These procedures used to be performed by electrocauterisation of appropriate ganglia but the technique is no longer used due to these risks as it is irreversible and ganglions cannot be renewed. The use of a metal clamp in the sympathectomy of the upper sympathetic ganglia is completely safe and very effective.

Perceptions and feelings after the procedure

As the procedure is performed in general anesthesia, each patient’s reaction to the procedure depends predominantly on the patient’s sensitivity to anesthesia. Some may feel ill, others are tired. Most patients can be dismissed into home care a day after their procedure.
Minor pain in the chest, particularly in women who have smaller pleural cavities, may persist for up to a month.

When to decide for surgery?

The procedure is advisable for all adults with hyperhidrosis, i.e. those who sweat excessively in certain areas of the body, and people who blush excessively. There is no age limit so the operation can, with the consent of parents, also be performed on teenagers who suffer from excessive perspiration from childhood. Before the operation, diagnostic procedures must exclude the presence of other illnesses which may cause excessive perspiration. These include thyroid conditions, diabetes, various malign diseases of lymphatic tissues and tuberculosis. Excessive sweating is mostly due to the thyroid, so it is sensible to examine its functioning prior to commencement of a surgical procedure. Patients always undergo basic laboratory tests.

It should be noted that treatment with video thoracoscopic sympathectomy is only idicated for the areas of the palms, face and underarms. If excessive sweating occurs in other parts of the body, nerve connections must be intercepted in other areas outside the chest, which is the domain of thoracic surgery. Sweating of the feet, for example, requires interception of nerves in the lumbar area, but the procedure may cause urological problems and is therefore not used. The same applies for sweating on large areas of the body, such as the abdomen or back. Procedures that will be able to effectively prevent excessive sweating in other areas may be developed in the future, but the solution for those suffering from excess blushing and sweating in the upper body is at hand, allowing them to lead a confident and happy life.

Blushing and beads of sweat under the arms, on the palms or face will be just a distant memory.

Costs of the procedure

Our clinic performs such procedures for private patients. Your appointment can be scheduled by phone. The waiting period for admission and surgery is approximately 14 days.