ETS surgery for excessive sweating

  • Best ResultsImmediate
  • Treatment Recovery4-7 days
  • Procedure Time60 minutes
  • Skin SpecialistVascular surgeon
  • Duration of ResultsLifetime
  • AnaestheticGeneral
  • Back to Work3-7 days
  • Cost$$ (Medicare)

ETS surgery for excessive sweating

Endoscopic thoracic sympathectomy or ETS is a surgical procedure to decrease sweat production by interrupting the nerves that cause excessive sweating. This procedure can be highly effective and is ideally suited for patients who suffer palm, underarm and facial sweating, or other forms of sweating that are resistant to other methods of treatment.

FactsFacts on ETS Surgery for Sweating

  • This is a highly specialised procedure conducted by a vascular surgeon
  • Success rate for reducing or eliminating excess sweat production is very high and can be expected to exceed 90%.
  • The procedure involves cutting the sympathetic nerves behind the chest wall that supply the sweat glands in the arm and hand
  • Rebound sweating can be expected elsewhere on the body in most cases
  • Patients should always consider and try non-surgical treatments for excessive sweating prior to undergoing ETS
  • The effects of ETS should be considered a permanent result with recurrence rates extremely low
  • In addition to reducing sweating in the palm, armpit, and face, ETS can also reduce excessive flushing & facial blushing

What is ETS surgery for sweating?

This is a surgical procedure conducted by a vascular surgeon in hospital under general anaesthesia. It results in the interruption of nerve signals from the spinal column to the eccrine (sweat) glands. This in turn decreases or eliminates the signal to produce sweat. Once performed, the procedure and effects should be considered permanent.

Careful consideration should be given, as one of the side effects is compensatory or rebound sweating. 

How effective is ETS surgery?

This form of sweat treatment is very effective. The results are immediate – when the patient wakes from the anaesthetic, the palms will be completely dry and warm. The success rate for alleviating palmar sweating exceeds 90%, and for the reduction of armpit sweating is over 80% effective.

It should be stressed that medical therapy is recommended prior to considering surgical intervention. The success rate for treating facial sweating and blushing is approximately 70-80%. Results are permanent. 

What areas can be treated with ETS surgery?

ETS can be employed to treat severe sweating of the hands, face, scalp and armpits.

Sweating of the face and scalp can be so severe that sweat can profusely flow, despite comfortable environmental temperatures. In some cases, this type of sweating can also be associated with flushing and blushing. This location of sweating is often the most debilitating and can be difficult to treat without surgery. Sweat stopping treatments injections can be used in certain areas such as the forehead and scalp, but if sweating in other areas of the face, this treatment is not as useful. In this location, patients should discuss the procedure of ETS with a Specialist Surgeon.

Sweating of the hands can also be treated by ETS. In general most dermatologists will encourage patients to try non-surgical methods of treatment for sweaty palms prior to the consideration of ETS. Treatments such as Driclor, Iontophoresis and sweat stopping treatments should be considered for excessive sweating in these locations first.

Armpit sweating can also be treated with ETS, with success rates of up to 85%. ETS for excessive sweating in this area has largely been replaced by sweat stopping treatments (Botox).

Who performs ETS surgery?

ETS is performed in hospital in an operating theatre by a specialist Vascular Surgeon. The procedure requires a general anaesthesia conducted by an anaesthetist. The surgeon of choice in Queensland is Dr Andrew Cartmill, as he is very skilled in this procedure.

Davin’s Viewpoint on excessive sweating ETS surgery

As a dermatologist my role is to guide patients to appropriate medical treatments with low side effects, acknowledging that there will be some cases resistant or recalcitrant to Botox injections, medications & iontophoresis. If all treatments have failed, I refer patients to a vascular surgeon for management. 

Dr Andrew Cartmill is a vascular surgeon in Brisbane who performs ETS, his statement is below.

Excessive sweating can be a very debilitating problem for many people, and it often interferes with work duties and daily activities. Many of my patients find the condition extremely embarrassing, and are concerned about odours, shaking hands and wet stains on their clothing. Indeed, it can pose significant safety concerns when driving or operating machinery.

There are many treatment options for excessive sweating, and with the help of a medical team-based approach, a methodical progression through the treatment regimens available is the ideal way to tackle this problem. My expertise lies with performing minimally invasive thoracic sympathectomy surgery. This procedure is safe, and extremely effective. The results are both dramatic and instantaneous and should be considered permanent. My patients are always shocked to wake from the anaesthetic with completely dry, warm hands that for most of their adolescent and adult life, have been moist and clammy.

Like any surgical procedure, patients need to be well-informed of the risks and benefits of surgery, with a good grasp of the expectations after the procedure. I always ensure that these discussions are very comprehensive.

After trialling other medical therapies for hyperhidrosis without success, thoracoscopic sympathectomy is an extremely effective treatment solution which has been used successfully for decades. It is especially suited to excessive palm and facial sweating. When performed by a trained specialist surgeon, it is a well-tolerated procedure with impressive success rates for which most patients are very grateful to have undergone.

Join the conversation

Join Dr Davin Lim on Instagram to stay up to date


Enquire now!

Get In Touch

Quick Contact

Dr Lim has unparalleled experience in dermatology. Fill in the form below and he will get back to you with your query
This field is for validation purposes and should be left unchanged.