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Limiting the indications for ETS

Dr. Reisfeld has been stating for several years that ETS should be conducted only for sweaty hands and feet. All other indications, including facial blushing, facial sweating and axillary sweating have not been alleviated properly with Endoscopic Thoracic Sympathectomy. Dr. Reisfeld's claims were recently reinforced by a paper published at the Mayo Clinic Proceedings in May of 2005. Dr. Reisfeld believes that the results of the paper reflect his own vast experience with sympathectomies. As previously stated on this website and others, any patient with severe hand sweating or palmar Hyperhidrosis should first try conservative treatment. Please see the Alternative Treatment of the site for further details.

Understanding ETS Controversies
It is interesting to see that a higher number of unhappy patients came from countries where ETS was done for reasons other than severe palmar hyperhidrosis. In those places facial blushing and facial sweating and axillary hyperhidrosis were quoted as the main reason for doing the ETS procedure. Those patients did not have the best results and also are left with bad side effects. This is the reason why Dr. Reisfeld, through his vast experience and research on this topic maintains his position that ETS should only be done for patients who suffer from severe palmar hyperhidrosis.

It is Dr. Reisfeld's belief that facial hyperhidrosis and or facial blushing should be treated with medications or other methods but no surgery. Axillary hyperhidrosis or armpit sweating should be treated with local measures such as suction curettage in order to prevent the generalized side effects such as compensatory sweating.