Unusual Sweating Phenomenon After Hand Sweat Surgery: A Case Study - Neurosurgery

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The Strange Phenomenon of Hand Sweat Surgery


Hello, doctor! I underwent surgery for axillary hyperhidrosis six years ago.
For the first two years post-surgery, I did not sweat at all above my neck and down to my palms, and my condition was good.
Starting from the third year, I noticed that whenever I ate certain types of fruit, those areas would start to sweat.
Initially, it was only when I ate apples, and consuming sour foods would also trigger sweating, so I thought it was just the stimulation from sour foods and didn't pay much attention to it.
However, gradually, the types of fruits that caused sweating increased, and now even eating bananas or guavas causes sweating in those areas that had never sweated before.
Even when I don't sweat, I experience goosebumps as if I'm about to sweat.
This makes me wonder if it's only related to eating sour foods.
I would like to ask the doctor if individuals who have undergone surgery for hyperhidrosis experience similar phenomena, and why this situation occurs.
Thank you.

Tali, 20~29 year old female. Ask Date: 2004/11/20

Dr. Xiao Furen reply Neurosurgery


This phenomenon is called gustatory sweating.
It has been suggested that it occurs because the parasympathetic (vagal) nerves have grown into the severed sympathetic nerves.
According to a recent report from Hong Kong, about one-third of patients with palmar hyperhidrosis experience this phenomenon after surgery.
Generally, consuming spicy or mildly acidic foods is more likely to trigger it.
However, the exact mechanism remains unclear.

Reply Date: 2004/11/20

More Info


The phenomenon you are experiencing after undergoing surgery for hyperhidrosis (excessive sweating) is known as gustatory sweating or taste-related sweating. This condition can occur in individuals who have had surgery to treat hyperhidrosis, particularly when the sympathetic nerves that control sweating are affected.
In your case, it seems that after a successful initial period of no sweating in the upper body, you began to notice that consuming certain fruits, particularly acidic ones, triggered sweating in areas that previously did not sweat. This is not an uncommon occurrence among patients who have undergone sympathectomy for hyperhidrosis. Research indicates that about one-third of patients may experience gustatory sweating post-surgery. The exact mechanism behind this phenomenon is not fully understood, but it is believed to be related to the reinnervation of the sympathetic nervous system.

When the sympathetic nerves are severed or altered during surgery, there is a possibility that the remaining nerves may adapt or change in response to the altered environment. This can lead to the phenomenon where certain stimuli, such as the taste of specific foods, can trigger sweating in areas that were previously unaffected. The fact that you initially only experienced this with apples and acidic foods, and later with other fruits, suggests that your nervous system may be responding to a broader range of stimuli over time.

It is also important to note that the body has a complex system of nerve pathways, and the sympathetic and parasympathetic nervous systems interact in ways that are not entirely predictable. The reorganization of nerve pathways after surgery can lead to unexpected outcomes, such as gustatory sweating.
While this condition can be bothersome, it is generally not harmful. However, if it significantly impacts your quality of life, it may be worth discussing with a specialist in dermatology or a surgeon who specializes in hyperhidrosis treatment. They may be able to provide further insights or potential management strategies.

In summary, your experience of sweating triggered by certain fruits after hyperhidrosis surgery is a recognized phenomenon known as gustatory sweating. It occurs due to the complex interactions of the nervous system following surgical intervention. If this condition continues to be a concern for you, consider consulting with a medical professional who can provide tailored advice and support.

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