Foot Sweating / Plantar Hyperhidrosis

Also known in the medical field asplantar hyperhidrosisis a common form of localized excessive sweating. It may not have the same social impact on the patient as hand sweating but can be very bothersome to people. Over the last few years when more follow-up on patients who had ETS done it became obvious that excessive foot sweating (plantar hyperhidrosis) can pose the same social and functional difficulties that patients have with excessive hand sweating. We also noticed that the success rate for plantar hyperhidrosis after performing ETS is not more than 20%. Stories like severe embarrassment from the smell, necessity to change shoes and socks are a common problem. This can also affect intimate settings and create marital or relationship issues. Developmentally, the foot sweat glands, mature somewhat later in life than the hand sweating glands. Many patients state that their excessive foot sweating did not become apparent until after they had an excessive hand sweating problem.


Since Lumbar Sympathectomy was introduced there has been a smaller sub group of patients that have emerged who only suffer from excessive foot sweating (plantar hyperhidrosis). These patients do not have an associated hand sweating (palmar hyperhidrosis). There is genetic pattern that affects only the plantar area and so far lumbar sympathectomy has been a good option for these severe cases of excessive foot sweating.


Lumbar Sympathectomy - Proven Surgery Specifically for Excessive Foot Sweating

Now lumbar sympathectomy is offered as a surgical solution for those cases with severe plantar hyperhidrosis or plantar foot sweating. It should always be remembered that attempts should be carried out with some of the conservative measures that are available such as drysol, drionic or anti cholinergic agents. Recent evidence from different centers in the world showed that this operation is very effective to treat excessive foot sweating. This operation cannot be done at the same time as Thoracic Sympathectomy. An average of three to four months is needed to perform both operations. This is a cautious approach to ensure the body responds well to each operation. At present a good percentage of patients have the procedure done on an outpatient basis.


Updated Information:

This operation is done endoscopically and there are three small cuts made on the left and right side of the body (between the hip bone and the rib cage). In cases of technical difficulties, which is very rare, the surgery can be done in an open fashion through one incision and the difference in the amount of pain is minimal. At present not only is the operation done endoscopically but the operation can also be accomplished on an outpatient basis where the patient leaves the hospital on the same day.


One of the only doctors known to do this new approach in the U.S. is Dr. Reisfeld in Beverly Hills who is recognized as one of the leading authorities on this topic.


Sweaty feet as the sole presentation of hyperhidrosis appears in less than 5% of the patients. The majority of the patients will also have sweaty hands. As more time is gained more and more patients with only foot sweating (plantar) are coming for lumbar sympathectomy as their initial operation.


The Success Rates for Different Types of Procedures:


ETSis very successful for those suffering from focal palmar hyperhidrosis (Sweaty Hands). WithETSthose who also suffer from plantar hyperhidrosis (sweaty feet) the success rate is low. For those patients with remaining plantar hyperhidrosis the lumbar sympathectomy is now offered with a great deal of success. This is also true for people who suffer from isolated plantar hyperhidrosis and never had ETS done. The success rate of ELS is about 97 to 98%.

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