Effective Treatments for Hyperhidrosis: Surgery, Costs, and Side Effects

Excessive sweating?

Doctor: I have hyperhidrosis, with excessive sweating in my hands and feet, which has led to severe foot odor and even skin abnormalities on my feet.
I also experience excessive sweating in my armpits, with a strong odor.
What treatment options are available? What is the surgical process like? How much does it cost? What are the potential side effects?

Zhang, 10~19 year old female. Ask Date: 2004/09/07

Dr. Huang Ruiyun reply Dermatology

Actually, you shouldn't consider surgery right away.
You can buy antiperspirants containing ALUMINUM CHLOROHYDRATE at drugstores (such as Watsons), with a brand called BAN among others.
Most people experience significant improvement after using it continuously for several weeks, especially for underarm sweating.
Another option is Botox injections, but they are quite expensive, costing several thousand dollars per treatment, which may last through the summer, requiring re-injection the following year.
For sweating in the hands and feet, iontophoresis can be used, but there are not many hospitals equipped for this (National Taiwan University Hospital has it), so it's best to call and inquire first.
Surgery is the last resort, specifically neurosurgery for treating palmar hyperhidrosis, but there is no surgical option for plantar hyperhidrosis.
Some individuals may suffer from compensatory sweating after surgery.

Reply Date: 2004/09/07

More Info

Hyperhidrosis, or excessive sweating, can significantly impact an individual's quality of life, leading to discomfort, social anxiety, and skin issues such as fungal infections or odor. The condition can affect various areas of the body, including the hands, feet, and underarms. Fortunately, there are several effective treatments available, ranging from non-invasive options to surgical interventions.

Non-Surgical Treatments
1. Antiperspirants: Over-the-counter or prescription-strength antiperspirants containing aluminum chloride are often the first line of treatment. They work by blocking the sweat glands and can be effective for mild to moderate cases.

2. Iontophoresis: This is a non-invasive procedure that uses electrical currents to temporarily shut down sweat glands. It is particularly effective for hands and feet and typically requires multiple sessions.

3. Botulinum Toxin Injections (Botox): Botox can be injected into the affected areas to block the nerves that cause sweating. This treatment is effective for underarm sweating and can also be used for hands and feet. The effects usually last for several months, and repeat treatments are necessary.

4. Medications: Oral medications, such as anticholinergics, can help reduce sweating. However, they may have side effects, including dry mouth, blurred vision, and urinary retention.

5. Microwave Therapy: This treatment destroys sweat glands using microwave energy. It is primarily used for underarm sweating and can provide long-lasting results.

Surgical Treatments
For individuals who do not respond to other treatments, surgical options may be considered:
1. Endoscopic Thoracic Sympathectomy (ETS): This is a surgical procedure that involves cutting the nerves responsible for sweating in the hands. While it can be highly effective, it carries risks, including compensatory sweating (increased sweating in other body areas), which can be a significant downside.

2. Sweat Gland Removal: In some cases, surgeons may remove sweat glands from the underarms or other areas. This procedure can be effective but may leave scarring.

Costs
The cost of treatment can vary widely based on the method chosen, geographic location, and healthcare provider. Here’s a rough estimate:
- Antiperspirants: $10 - $50 for prescription-strength options.

- Iontophoresis: $300 - $800 for a device, with additional costs for supplies.

- Botox Injections: $1,000 - $2,000 per treatment session, depending on the area treated and the number of units required.

- Microwave Therapy: Approximately $1,500 - $3,000 per treatment.

- Surgery (ETS): Costs can range from $5,000 to $10,000, including hospital fees and anesthesia.

Side Effects and Risks
Each treatment option comes with its own set of potential side effects:
- Antiperspirants: Skin irritation or allergic reactions.

- Iontophoresis: Mild discomfort during treatment.

- Botox: Temporary weakness in the treated area, pain at the injection site, and potential flu-like symptoms.

- Microwave Therapy: Swelling, pain, and potential skin burns.

- Surgery: Risks include infection, bleeding, compensatory sweating, and nerve damage.

Conclusion
If you are struggling with hyperhidrosis, it is essential to consult with a healthcare professional who can evaluate your specific situation and recommend the most appropriate treatment options. They can help you weigh the benefits and risks of each treatment, considering your lifestyle and preferences. With the right approach, you can effectively manage your symptoms and improve your quality of life.

Similar Q&A

Understanding Hyperhidrosis: Treatment Options and Surgical Insights

Hello, Doctor! I am someone who suffers from palmar hyperhidrosis. I have come across some questions raised by others online that are very similar to my situation, but they remain unanswered. I would like to know the answers to these questions as a basis for deciding whether to u...

Dr. Xiao Furen reply Neurosurgery
1. The best results are typically achieved with T2 + T3, but compensatory sweating may be more severe. Some say that performing only T2 or T3 + T4 may result in less compensatory sweating, although I have also seen cases where T3 + T4 was performed and there was still palmar swea...

Understanding Axillary Hyperhidrosis: Surgery, Botox, and Costs Explained

Will removing the apocrine glands in the armpits reduce the amount of sweating? What type of surgery can ensure there is no compensatory sweating? Can botulinum toxin be used to treat axillary hyperhidrosis? How is the cost calculated? Please help me with these questions. Thank y...

Dr. Lu Daokuan reply Plastic Surgery
Axillary hyperhidrosis is not the same as palmar hyperhidrosis, and a major sweat gland excision can reduce sweat production. Compensatory sweating occurs only after sympathetic ganglionectomy. The cost for gland excision is approximately NT$20,000. Botulinum toxin injections can...

Understanding Hyperhidrosis: Surgical Options and Risks for Teens

My 14-year-old daughter is quite troubled by her body odor. I would like to consult a doctor about whether surgery has any potential side effects and if there are other treatment options available.

Dr. Luo Qihua reply Plastic Surgery
Hello: Please refer to the response dated August 1, 2002. The excision of apocrine glands (sweat glands) is similar to a skin graft procedure, and it is necessary to restrict the movement of both shoulders for one week post-surgery to prevent graft failure. Possible complications...

Understanding Hyperhidrosis: Which Specialist to Consult and Surgery Costs

Which specialty should I consult for palmar hyperhidrosis, and if surgical treatment is required, what would the cost be? Thank you!

Dr. Ding Xianwei reply Neurosurgery
Hyperhidrosis is not a disease but a symptom. The most commonly used method for treatment is endoscopic sympathetic nerve resection. If the surgery goes smoothly, it takes about half an hour, and with anesthesia before and after, the total time is approximately three to four hour...