Hyperhidrosis Surgery Service

About the Hyperhidrosis Surgery Service

The Hyperhidrosis Surgery Service at Massachusetts General Hospital uses a minimally invasive surgical approach to managing upper-body hyperhidrosis (excessive sweating) for qualifying patients.

Our surgical team includes board-certified thoracic surgeons who have a long history of treating hyperhidrosis. Our surgeons perform the full range of thoracic surgery, bringing a level of skill and expertise to help ensure patient comfort and safety.

Since 1995, Mass General has offered a full range of care options to hyperhidrosis patients. Combining state-of-the-art technology with our tradition of surgical excellence, our minimally invasive treatment approach has proven to:

• Decrease incision size
• Hasten an individual’s return to full activity
• Reduce postoperative recovery time

Although surgery for hyperhidrosis is relatively simple, as with all operations, it still carries some risk. At Mass General, patients undergo the procedure at a world-renowned hospital that provides safe, high-quality care in virtually every specialty and subspecialty of medicine and surgery.

About Hyperhidrosis

Hyperhidrosis occurs when the body creates perspiration in excess of what is necessary to cool itself. The process of sweating is controlled by the sympathetic nervous system. This involuntary nervous system controls millions of sweat glands throughout the body, including many glands located in the hands.

Our bodies naturally sweat to regulate body temperature. When this condition affects the hands (palmar hyperhidrosis) or armpits (axillary hyperhidrosis), it can have a dramatic impact on the patient's everyday life. In many cases, it can compromise his or her ability to function in the workplace and at home.

Our surgical approach, thoracoscopic thoracic sympathectomy, can eliminate palmar hyperhidrosis and also can help decrease armpit perspiration.

Palmar Hyperhidrosis: Hand Sweating

Excessive hand sweating, known as palmar hyperhidrosis, is the most common presentation of hyperhidrosis. Excessive hand sweating can be quite severe by affecting a patient's life both functionally and socially.

In most patients, the problem is genetic. Palmar hyperhidrosis usually begins in childhood and becomes more severe toward early adulthood.

Axillary Hyperhidrosis: Armpit Sweating

Some armpit sweating and odor is normal in all people past puberty. When excessive, it is termed axillary hyperhidrosis.

Topical deodorants and antiperspirants may be an appropriate treatment for some patients, and thoracoscopic thoracic sympathectomy may be an appropriate axillary hyperhidrosis treatment, which can offer benefits to some patients with this complaint.

Treatment

Patients undergo a comprehensive evaluation of their condition to determine the best approach to managing their upper body hyperhidrosis. Most patients are treated initially with several medical interventions in the hope of avoiding surgery.

For patients with severe hyperhidrosis who have failed nonsurgical treatments, we may recommend a procedure known as thoracoscopic thoracic sympathectomy. This minimally invasive procedure is performed through several small incisions in each armpit.

While the patient is under anesthesia, a small scope with a camera is inserted into the chest cavity. The surgeon can then identify and interrupt the nerve ganglia that are responsible for the excess sweating. This technique optimizes the patient’s result and reduces the occurrence of complications. Most patients treated with this technique can leave the hospital within hours and resume normal activities within one week.