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Surgery May Permanently Fix Sweaty Palms

Armen Hareyan's picture

Sweaty palms treatment

A new procedure may offer a permanent solution to an often-sticky problem - sweaty palms.

The minimally invasive procedure, called a sympathectomy, severs sections of overactive sympathetic nerves in the chest wall, which cause excessive sweating, also called hyperhidrosis. The effects of the surgery are almost immediate, said Dr. Joseph Coselli who performs the surgery at The Methodist Hospital in Houston.

"Patients have come to see me with sweat literally dripping off their hands," said Coselli, chief of cardiothoracic surgery in the Michael E. DeBakey Department of Surgery at Baylor College of Medicine. "A couple of days after the surgery their hands are completely dry."

An estimated one out of every 500 Americans has hyperhidrosis. The condition causes excessive sweating, which can affect a person socially and at work. Patients with hyperhidrosis may avoid shaking hands with others. Excessive sweating may also cause pens and pencils to slip out of the grasp of perspiring hands.

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Current treatments to alleviate excess sweating include antiperspirants, to decrease the secretion of sweat and medications to reduce sweating. More lasting solutions include iontophoresis, which involves passing a mild electrical current through tap water to shut of the sweat glands temporarily.

In order to treat sweaty palms or underarms, a small part of the sympathetic nerve responsible for excessive sweating is removed. In the past, this required a large incision in the chest. Many muscles were cut and ribs separated in order to expose the sympathetic nerve chain. Recent surgical advances have produced less invasive procedures, such as the endoscopic thoracic sympathectomy.

This procedure requires general anesthesia and typically takes less than an hour to complete.

"We make two or three small incisions below the armpit," Coselli said. "Through these tiny holes, a miniature video camera is used to locate the sympathetic chain. Through the other incisions, special instruments are placed allowing me to remove a small segment of the nerve to ensure that the treatment is permanent. We then perform the same procedure on the opposite side of the patient's body."

The patient usually stays in the hospital for an additional 12 to 24 hours following surgery. The success rate for the procedure is 85 percent to 95 percent. A small percentage of patients may experience excessive sweating in other areas of the body, such as the chest, back and legs. For many patients, the side effect is not as severe as the original problem and is considered to be manageable.