For the most extreme cases of hyperhidrosis, surgery is a possible route, although it is also generally viewed as the riskiest treatment. Endoscopic Thoracic Sympathectomy (also called Endoscopic Transthoracic Sympathectomy or ETS) disables specific nerves responsible for sweating in certain parts of the upper body by cutting or clamping them. ETS is most successful and most commonly performed in cases of severe palmar hyperhidrosis. In the lower body, a similar procedure called lumbar sympathectomy can be performed for plantar hyperhidrosis.
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The different treatments for hyperhidrosis attack excessive sweating in various ways.
Other surgical approaches can include localized procedures, like cutting, scraping or suctioning the sweat glands out, or they may involve a combination of these techniques. Along with the previously described methods, most of these carry some risk of side effects, so a competent doctor should be consulted concerning each.
A particular dissatisfying side effect from surgery is compensatory sweating. Because the body already has an inclination to sweat excessively, it believes it must produce the same amount of sweat after surgery and finds new areas to release that sweat. A patient who undergoes ETS, for example, may be disappointed to find that although his hands no longer sweat excessively, now his back and stomach are overcompensating for that loss of sweat. Researchers are seeking ways to tweak these treatments in order to decrease occurrences of compensatory sweating and other side effects.
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