Excessive sweating now has less invasive treatment

Oct 25 2004

For about one percent of Americans, excessive sweating isn’t just embarrassing; it’s a condition that warrants medical treatment. Now, a minimally invasive, endoscopic approach available at Georgetown University Hospital allows patients to receive this treatment and go home the same day.

People who suffer from excessive sweating or hyperhidrosis find it very stressful to live with this condition, according to Blair Marshall, MD, chief of thoracic surgery at Georgetown University Hospital. Dr. Marshall says that many hyperhidrosis patients’ lives are ruled by their excessive sweating. “They find it almost impossible to exist is a world where we make introductions to everyone from potential employers to business contacts by shaking hands. Younger patients who take written exams are traumatized by handing in sweat-soaked papers to their professors, and patients can literally wear the venir finish off their desk from so much sweating.”

Our bodies naturally perspire to regulate the temperature. Excessive sweating can be isolated to the palms of the hands, under arms, feet and even the head. Sweating is controlled by the sympathetic nervous system, which maintains the more than five million sweat glands in the body; more than two thirds of those are located in the hands alone. For those suffering from hyperhidrosis, the signals are sent from the sympathetic nervous system to the sweat glands too often and too fast, causing an overproduction of sweat usually in the face, hands or underarms.

To correct this, Dr. Marshall is performing endoscopic thoracic sympathectomy. The procedure starts with Dr. Marshall making two needle holes in the under arm area. Then, using endoscopic equipment that includes a small camera, she can locate the specific nerves and divide them. This essentially blocks the signal from the sympathetic nervous system to the sweat glands. The procedure takes about an hour and patients go home the same day. The results are immediate.

“This is much less invasive and has a much quicker recovery time than the traditional minimally invasive sympathectomy, which involved opening three incisions on each side of the chest, chest drainage tubes and a few days in the hospital,” Dr. Marshall said.