Excessive Sweating: Axillary Suction Curettage vs. Sympathectomy

Excessive sweating, or Hyperhidrosis, occurs in the areas of the underarms, palms, feet and face. It is a nonthermoregulatory sweat response that affects about 10% of the population. There are several treatments to try, including the use of Drysol, a prescription only medication and iontophoresis, a treatment that distributes a small electrical current to the sweat glands that disrupts sweat production. Other treatments include medical therapies, such as Botox injections.

Once these treatment options have been tried and the problem still persists, many patients turn to surgical options, such as Axillary Suction Curettage or Sympathectomy.

Sympathectomy Procedure

Sympathectomy is a surgical procedure, often performed on an outpatient basis under general anesthesia, that destroys the nerves, either by cutting or clipping, in the sympathetic nervous system. For treatment of hyperhydrosis, the ganglia, which are collections of nerve cell bodies along the thoracic or lumbar spinal cord, are cut or destroyed with a laser beam. It results in minimal side effects and a projected excellent outcome. The procedure does leave permanent, though minimal scarring. It can also be performed endoscopically, with no scarring. Patients will be abe to resume their normal activities after one week. In some cases, this procedure is covered by medical insurance, especially if it's proven that it interferes with the ability to do your job.


The risks and possible complications can be serious. Some of thee most common side effects of the sympathectomy surgery include fainting due to decreased blood pressure, infertility in male patients, air in the chest cavity (pneumothorax), chest or rib pain, or compensatory hyperhydrosis (excessive sweating in other areas, like the chest). In very rare cases, the procedure can cause death, due to low blood pressure. It is typically performed by a thoracic surgeon. The average cost is between $10,000 and $20,000.

Axillary Suction Curettage

Axillary suction curettage's average cost is between $4000 and $7000 dollars. This procedure removes the sweat glands and is considered to be less invasive than sympathectomy. It is commonly compared to liposuction procedures. The physician will insert a cannula into the skin and suction is applied to remove sweat glands. This procedure may be covered by insurance, and it's a good idea to check with several clinics and get quotes from each of them. It is usually recommended only if other treatments don't work.

Since it is only used on the axillary or armpits, its considered a treatment just for armpit sweating. For most people, it does result in a reduction in sweat, and the treatment is hopefully a permanent solution. Although it doesn't have as many side effects as a Sympathectomy surgical procedure, it is also considered not to be as completely effective.

Compensatory Sweating

With both types of surgery, it's best to consider that sometimes patients will have to live with compensatory sweating. This is a common side effect and can include night or sleep hyperhidrosis. Slow healing wounds can be a problem, as well as scarring. However, for patients who are living with excessive sweating that affects them socially and professionally, the risks are worth the surgery.

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