Sweaty Feet - Foot Sweating

Excessive sweating in different locations of the body is known as focal hyperhidrosis. In contrast to excessive sweating all over the body which can described as generalized hyperhidrosis.

The most common sites for focal hyperhidrosis are excessive hand sweating, excessive foot sweating and excessive armpit sweating. Conservative measures are available such as medications, lotions or electrical instruments to try and alleviate these problems. Earlier in the history of surgical interventions to treat palmar hyperhidrosis it was thought that plantar hyperhidrosis could be alleviated as well. Unfortunately the success rate in reducing plantar hyperhidrosis (foot sweating) after performing endoscopic thoracic sympathectomy is much less than anticipated. As more experience was gained now a days lumbar sympathectomy is offered as a more effective solution to treat isolated plantar hyperhidrosis or those cases that ETS did not make any difference.

The operation of endoscopic lumbar sympathectomy (ELS) is performed under general anesthesia and can be accomplished also on an outpatient basis. It involves three small cuts on either side of the abdominal cavity. The space in between the abdominal cavity and the posterior back muscles is entered into the lumbar region where the sympathetic chain runs. There at a particular location the sympathetic chain is clamped or divided. So far with ELS, only the clamping method was used by Dr. Reisfeld. It gives the surgeon a definite idea about the level at which the nerve was clamped. The less dissection that is required results in a more efficient procedure with less pain. The operation takes about an hour and a half with a success rate of about 97-98%. Usually the amount of pain is quite small and patients are able to go back to their normal day to day life in a very short amount of time. The muscles are not cut but split so there is no loss of muscle power and everything goes back to normal.

Side effects include some discomfort and rarely scar formation. Compensatory sweating is usually kept at the same level for those patients who had a previous endoscopic thoracic sympathectomy. For those patients who have only ELS the compensatory sweating so far did not mature to be of a significant level.

Causes of foot sweating
As stated, focal hyperhidrosis affects hands, armpits and feet. When someone is affected by all three of these the most likely explanation is a genetic one. It was shown in multiple studies that more than 50%, of the patients experiencing excessive sweating, have a family history with it. Even when there is no definite family history a gene mutation may have occurred or that family history is not obvious. Hyperhidrosis is not always something people are comfortable talking about.

See also Dr. Reisfeld's Foot Sweating hyperhidrosis page

Obviously conservative approaches should be tried before any consideration of surgical intervention.

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Frequently Asked Hand Sweating Questions:

Can ETS (hands) and ELS (feet) be done at the same time?
The short answer is no however most of the patients that suffer from severe palmar hyperhidrosis (hand sweating) and plantar hyperhidrosis (foot sweating) are having thoracic sympathectomy first and then 3 to 4 months later endoscopic lumbar sympathectomy. The reason for the delay is to ensure physiological adjustment of the body to the initial procedure.

What are the most common side effects for the ELS procedure?
As in any operation side effects such as pain, discomfort and scar formation are common but on a very limited and mild basis. Compensatory sweating, which is the most frequent side effect after ETS, does not change after ELS. Various medical papers have been published on this matter however the research and study is ongoing.

Can ELS be done if I had previous abdominal operations?
Yes. ELS is done not through the abdominal cavity but through the abdominal wall muscles so there should be any entry into the abdominal cavity. Previous operations should not be a contra indication to perform ELS but always other factors such as obesity may have an impact.