What if I only have armpit and foot sweating?

The typical cases that influence the surgeon with the decision who is really fitting into the surgical treatment of focal hyperhidrosis (hands, armpit and feet) which did not respond to conservative measures are those cases that have severe hand sweating, feet sweating and armpit sweating if they suffer from that site as well.

Often the question is asked to us, “What if I only have armpit sweating and severe foot sweating?” For those surgeons who are familiar with these presentations it poses a relative dilemma when the hands are not a part of these three mentioned above. The technical aspect of doing lumbar sympathectomy for those patients with excessive feet sweating is available providing that the patient first tried conservative treatments and he/she is not extremely overweight and does not have any other associated medical problems. That particular operation will not affect axillary sweating at all. Also the fact that before the operation they did not complain about hand sweating does not mean that in the future after performing lumbar sympathectomy they will not develop also palmar hyperhidrosis (hand sweating). It is somewhat a difficult topic to enlighten all inquiries about this particular combinations of excessive sweating so it is highly recommended that the patient discusses this with an experienced surgeons.

Anecdotally in the past a trial to perform ELS for patients with only plantar hyperhidrosis (feet only sweating) was not as successful as thought to be. Not that there were any technical issue but the physiological outcome was not as we hoped it to be. These particular cases of plantar (foot) sweating only was originally limited to these patients from the East horn of Africa. Those patients did not have any other site of sweating but the feet. Those patients who have severe axillary hyperhidrosis as well as feet sweating it is our belief that they can fit into the grand picture / whole picture of hyperhidrosis and those can be benefitting from ELS to solve their problem but not the armpit problem. Again it should be emphasized that because of the complexity of those questions it is a must for a potential patient to discuss this subject deeply with an experienced surgeon.

With more information that comes as the time goes by. We believe that cases with only plantar sweating and especially if they come later in life (mid 20s onward) are not a good candidate for the ELS procedure. No good explanation is available and because it does not have all the traits of primary focal hyperhidrosis this operation should not be done in those circumstances.