Hyperhidrosis: Which Specialist to Consult and Surgery Costs

Palmar hyperhidrosis

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

Douzi, 20~29 year old female. Ask Date: 2000/10/31

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 hours.
The procedure requires general anesthesia and the use of a double-lumen endotracheal tube.
Postoperatively, in addition to the risks associated with general anesthesia and typical surgical complications, there is a chance of developing pneumothorax or hemothorax, with reports of fatalities both domestically and internationally, although the risk is relatively low.
After the surgery, some individuals may experience compensatory sweating, where sweating occurs more in the chest and abdomen due to the lack of sweating in the hands.
Some patients may find this unacceptable; therefore, surgery should only be considered if hand sweating significantly impacts quality of life.
The surgery is covered by health insurance, and it is advisable to stay in the hospital for three days for safety.
The patient’s out-of-pocket cost is 10%, and the total surgical expenses should not exceed NT$10,000.
Both neurosurgeons and thoracic surgeons are qualified to perform the procedure.

Reply Date: 2000/10/31

More Info

Hyperhidrosis, or excessive sweating, is a condition that can significantly impact an individual's quality of life. When it comes to seeking treatment for hyperhidrosis, the first step is to consult with a specialist. The most appropriate specialists for this condition are dermatologists or surgeons specializing in hyperhidrosis treatment. Dermatologists are trained to diagnose and manage skin-related conditions, including hyperhidrosis, and can offer various non-surgical treatments such as topical antiperspirants, oral medications, and botulinum toxin injections (Botox).
If non-surgical treatments are ineffective, you may be referred to a surgeon who specializes in procedures for hyperhidrosis. One common surgical option is sympathectomy, which involves cutting nerves that trigger sweating in the hands. This procedure can be performed using minimally invasive techniques, such as endoscopic thoracic sympathectomy (ETS).
Regarding the costs associated with surgery for hyperhidrosis, these can vary widely based on several factors, including the surgeon's experience, the facility where the procedure is performed, and the geographical location. In the United States, the cost of sympathectomy can range from $5,000 to $15,000 or more. This estimate typically includes pre-operative consultations, the surgery itself, and post-operative follow-up visits. However, it is essential to check with your insurance provider, as some plans may cover part of the costs if the condition is deemed medically necessary.

In addition to the financial aspect, it is crucial to consider the potential risks and benefits of surgery. While many patients experience significant relief from their symptoms, there can be complications, such as compensatory sweating in other areas of the body, which some patients find bothersome. Therefore, discussing these concerns with your healthcare provider is vital to make an informed decision.

Before proceeding with any treatment, it is advisable to explore all available options, including lifestyle modifications and non-invasive treatments. For instance, wearing moisture-wicking clothing, using absorbent pads, and practicing stress-reduction techniques can help manage symptoms.
In summary, if you are experiencing hyperhidrosis, start by consulting a dermatologist who can evaluate your condition and recommend appropriate treatments. If surgery is considered, be sure to discuss the costs, potential risks, and expected outcomes with your healthcare provider to ensure you make the best decision for your health and well-being.

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