My Life as a Puddle

Creating hyperhidrosis hope and awareness one drop at a time

ETS Surgery for Hyperhidrosis

Some of you have asked why haven’t I had endoscopic thoracic sympathectomy (ETS) surgery. ETS is a very serious medical procedure that most people with hyperhidrosis turn to as a last resort for relief. There are pros and cons to this procedure, and the side effects, especially compensatory sweating (CS), are real and do occur. I spoke in person to someone who had ETS performed when I went to a hyperhidrosis symposium. We spoke for about 20 minutes, and he was sweating through his black T-shirt the entire time. He came to the symposium seeking Botox treatment for relief from compensatory sweating. While his original sweating had been cured, he was still suffering from the side effects of ETS surgery.


Because compensatory sweating can be worse than the original sweating, many people are now turning to subdermal laser ablation (SDLA) for secondary relief. SDLA typically is not covered by insurance and can range in price, with the upper end being around $10,ooo. For a treatment that isn’t guaranteed to work. I’ve also spoken with someone who has ETS and is now trying SDLA; she, I believe, is going through multiple rounds of treatment in an attempt to stop the compensatory sweating in her trunk area.


Only you can decide whether ETS surgery is something you want to pursue. Like any medical procedure, there are risks and benefits. The hard part about ETS is that you won’t know whether the treatment will work until after you’ve had it. They say the CS can lessen over time, but for me, this is a side effect that would be worse than my original palmar and plantar hyperhidrosis. I already experience CS on my back after having Botox. I am not willing to subject myself to a procedure that is not guaranteed to work, is a serious medical procedure, and would most likely make me sweat in a different area of my body that could be more socially and professionally debilitating and harder to hide. I don’t want to have to worry even more about the types of clothes I can wear, completely sweating through my clothes and drenching a seat, or the damaging emotional impact from sweating even worse than I already do. I deal with my inner monologue enough as it is. I don’t want to give it the surround sound IMAX experience.


Once the nerves are ablated from ETS surgery, there is no going back. ETS is a permanent procedure. There have been no effective ETS surgery reversals reported. If you are considering ETS, please do your homework. Pay attention to the sources from where you are gathering information. Most search engine results will tout the awesomeness of ETS surgery. Of course they will. They want your money. Find a physician who is connected with the International Hyperhidrosis Society (IHHS) using their Physician Finder. These physicians are IHHS-approved and will have better knowledge about hyperhidrosis. They have an arsenal of information and other treatments for hyperhidrosis besides surgery.


I’m not saying there aren’t successful ETS procedures performed. Some people do have great results. Only you can decide whether ETS is right for you.


To understand more about where I’m coming from regarding ETS surgery and how my body has responded to the treatments I’ve tried to stop my excessive sweating, you can read my post Reflections on Botox.

Copyright © 2012 My Life as a Puddle


  1. Hi Maria, I just recently dicovered your blog and let me say you thank you so much for doing this. I can finally have someone to releate to, I suffer from HH all my life (hands, underarms and feet) On 2004 I had the ETS surgery and it was like a dream come true for a few days that my hands were no longer sweating but then my worse nightmare began now I suffer from compensatory sweating and it has been a struggle ever since, My underarms and feet sweat even more than before, and also the rest of my body and living in Phx, AZ makes it evern worse. I really regret having the surgery done. I can’t do any outdoor activities. Is just horroble, I dream of having a dry day just once in my life. But I don’t know if that ever going to happen for me!

    • Hi Ana! I’m so sorry that you are suffering from CS. I used to live in Phoenix, too. The summers there are so difficult when you have hyperhidrosis! The next time I come to Phoenix I will contact you. Maybe we could meet in person. 🙂

    • So so so important to get the word about ETS Surgery and the side effects. Glad to see this posted. I wish I knew there were other options. So many doctors do not know the options available so we must be our own advocates/researchers.

  2. Maria,

    Have you considered the new microwave technology treatment, miraDry? The reviews and patient testimonials about the relief they’re experiencing regarding hyperhidrosis of the axilla seems very promising. Just an idea and something new on the market with significant clinical support of efficacy vs. SDLA.

    • Hi Jeff,

      I am familiar with MiraDry, but I don’t feel like I sweat enough in the axillary (armpit) area to warrant getting the treatment. Neither would I get SDLA for my back, as I haven’t even had the ETS surgery for the original problem. My back sweating is worse post-Botox for palmar hyperhidrosis, but still not significant enough that I feel surgery is warranted.

  3. Have you heard of dehydral or antihydral? I have tried many things to stop my hands from sweating. This was the first thing that worked well for me. 90% improvement is what I feel it has done. Over 25+ years of trying all the different stuff that is said to help this has been the best. You name it I have tried it…luckily I was too scared to do the ETS after having a consultation. Only wish I had found these creams earlier

    • Hi Adam,

      I’ve heard of some similar creams, but not these. I’ve not tried any of them, but anything is fair game besides ETS surgery!

      • These 2 creams have basically the same active ingredient, methenamine, but a slightly different concentration. They are different then a lot of stuff I have tried. I have tried I think almost every topical antiperspirant but have never had success. And actually some seemed to make my hands sweat more. I have tried A LOT of the other cures as well which never panned out. Topical, prescription drugs, iotophoresis, supplements, etc. over the years. Botox worked a good bit when it was administered properly but was way too expensive and a doctor visit I could do without. This is the one I will stick with until something better comes along. A couple nights a week and I am good. Can’t beat it for now. It broke my cycle of worry over the issue. Now it comes into my head hardly at all. Figured I would pass on the info. and possibly save someone the time and effort.

  4. Hi, I just subscribed to your blog today after visiting it once in awhile for the past few months. I think what you are doing is so terrific. I have had hyperhidrosis for over 20 years and I still find it so difficult and embarrassing to deal with or even talk about. About 10 years ago I began using the Fischer Galvanic iontophresis machine and it has helped tremendously. Unfortunately my skin is very sensitive and it does hurt a bit…usually giving me blisters. It’s pain I am willing to tolerate because having dry hands has made such a huge difference in my life. The amazing thing is that once I’ve done enough treatments not only do my hands stop sweating, my entire body stops as well. Sweating will return as the effects of the treatment wears off so I have to make sure I keep up with the treatments. I couldn’t find a post where you talk about trying iontophresis…and I was just wondering if you have and if you can give us HH sufferers any info on it. I got my machine so many years ago and I’m wondering if there are any better machines on the market that will actually hurt less and or be even more effective.

  5. Love your advocacy! Thanks for the heads up!

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