hyperhidrosis

Summary

Summary: Excessive sweating. In the localized type, the most frequent sites are the palms, soles, axillae, inguinal folds, and the perineal area. Its chief cause is thought to be emotional. Generalized hyperhidrosis may be induced by a hot, humid environment, by fever, or by vigorous exercise.

Top Publications

  1. Apiliogullari B, Esme H, Yoldas B, Duran M, Duzgun N, Calik M. Early and midterm results of single-port video-assisted thoracoscopic sympathectomy. Thorac Cardiovasc Surg. 2012;60:285-9 pubmed publisher
    Video-assisted thoracoscopic sympathectomy (VATS) is the gold standard for patients with hyperhidrosis of the upper limbs...
  2. Bejarano B, Manrique M. [Thoracoscopic sympathectomy: a literature review]. Neurocirugia (Astur). 2010;21:5-13 pubmed
    ..endoscopic (thoracoscopic) sympathectomy has rendered the open techniques obsolete in the treatment of the hyperhidrosis and other sympathetic-related diseases. AIM...
  3. Lyra R, Campos J, Kang D, Loureiro M, Furian M, Costa M, et al. Guidelines for the prevention, diagnosis and treatment of compensatory hyperhidrosis. J Bras Pneumol. 2008;34:967-77 pubmed
    With the objective of establishing guidelines for the prevention, diagnosis and treatment of compensatory hyperhidrosis, consensus meetings were held...
  4. Loureiro M, De Campos J, Kauffman P, Jatene F, Weigmann S, Fontana A. Endoscopic lumbar sympathectomy for women: effect on compensatory sweat. Clinics (Sao Paulo). 2008;63:189-96 pubmed
    Plantar hyperhidrosis is present in 50% of patients with hyperhidrosis. Thoracic sympathectomy is an important tool for the treatment of this condition, which is successful in about 60% of patients...
  5. Prasad A, Ali M, Kaul S. Endoscopic thoracic sympathectomy for primary palmar hyperidrosis. Surg Endosc. 2010;24:1952-7 pubmed publisher
    Primary hyperhidrosis is a disorder that is characterized by excessive sweating in disproportion to that required for thermoregulation. In most cases, this is aggravated by emotional factors and by heat...
  6. Wollina U, Köstler E, Schönlebe J, Haroske G. Tumescent suction curettage versus minimal skin resection with subcutaneous curettage of sweat glands in axillary hyperhidrosis. Dermatol Surg. 2008;34:709-16 pubmed publisher
    Axillary hyperhidrosis is a common problem with a strong negative impact on professional and social life. Various types of surgical procedures have been developed for its treatment.
  7. Try C, Messikh R, Elkhyat A, Aubin F, Humbert R. [Use of oral oxybutynin at 7.5 mg per day in primary hyperhidrosis]. Rev Med Liege. 2012;67:520-6 pubmed
    Oxybutynin is being increasingly being prescribed in the treatment of hyperhidrosis but currently, there is no precise dosage for this treatment...
  8. Grunfeld A, Murray C, Solish N. Botulinum toxin for hyperhidrosis: a review. Am J Clin Dermatol. 2009;10:87-102 pubmed publisher
    Primary focal hyperhidrosis is a disorder of idiopathic excessive sweating that typically affects the axillae, palms, soles, and face. The disorder, which affects up to 2...
  9. Yamashita N, Tamada Y, Kawada M, Mizutani K, Watanabe D, Matsumoto Y. Analysis of family history of palmoplantar hyperhidrosis in Japan. J Dermatol. 2009;36:628-31 pubmed publisher
    Palmoplantar hyperhidrosis (PPH) is a disorder characterized by excessive sweating of the palmar surfaces of the hands and feet due to emotional sweating...

More Information

Publications62

  1. Smidfelt K, Drott C. Late results of endoscopic thoracic sympathectomy for hyperhidrosis and facial blushing. Br J Surg. 2011;98:1719-24 pubmed publisher
    ..and overall satisfaction rates of endoscopic thoracic sympathectomy (ETS) used in the treatment of hyperhidrosis and facial blushing. Some 3015 patients had bilateral ETS from 1989 to 1998...
  2. Gorman P. Unilateral hyperhidrosis from a contralateral source in an individual with C4 complete tetraplegia. J Spinal Cord Med. 2010;33:428-30 pubmed
    ..patient's gel cushion was replaced with an air-filled cushion, providing significant ongoing relief from the hyperhidrosis. Unilateral hyperhidrosis can be caused by a contralateral source of irritation...
  3. Kopelman D, Hashmonai M. The correlation between the method of sympathetic ablation for palmar hyperhidrosis and the occurrence of compensatory hyperhidrosis: a review. World J Surg. 2008;32:2343-56 pubmed publisher
    Upper dorsal sympathectomy achieves excellent long-term results in the treatment of primary palmar hyperhidrosis. Compensatory hyperhidrosis (CHH) remains an unexplained sequel of this treatment, attaining in a small percentage of cases ..
  4. Aşik Z, Orbey B, Asik I. Sympathetic radiofrequency neurolysis for unilateral lumbar hyperhidrosis: a case report. Agri. 2008;20:37-9 pubmed
    Patients with hyperhidrosis suffer from physical, social and mental discomfort which often cannot be treated sufficiently using conservative measures...
  5. Tetteh H, Groth S, Kast T, Whitson B, Radosevich D, Klopp A, et al. Primary palmoplantar hyperhidrosis and thoracoscopic sympathectomy: a new objective assessment method. Ann Thorac Surg. 2009;87:267-74; discussion 274-5 pubmed publisher
    ..an objective approach to evaluate symptoms and sweat production in patients with primary palmoplantar hyperhidrosis (PPH) and assess their response to bilateral thoracoscopic sympathectomy (BTS)...
  6. Cerfolio R, De Campos J, Bryant A, Connery C, Miller D, Decamp M, et al. The Society of Thoracic Surgeons expert consensus for the surgical treatment of hyperhidrosis. Ann Thorac Surg. 2011;91:1642-8 pubmed publisher
    Significant controversies surround the optimal treatment of primary hyperhidrosis of the hands, axillae, feet, and face. The world's literature on hyperhidrosis from 1991 to 2009 was obtained through PubMed...
  7. Wolosker N, Krutman M, Campdell T, Kauffman P, Campos J, Puech Leao P. Oxybutynin treatment for hyperhidrosis: a comparative analysis between genders. Einstein (Sao Paulo). 2012;10:405-8 pubmed
    To assess the results of palmar and axillary hyperhidrosis treatment in males and females using low doses of oxybutynin...
  8. Fibla J, Molins L, Mier J, Vidal G. Effectiveness of sympathetic block by clipping in the treatment of hyperhidrosis and facial blushing. Interact Cardiovasc Thorac Surg. 2009;9:970-2 pubmed publisher
    Main cause of dissatisfaction after videothoracoscopic (VATS) sympathectomy in the treatment of hyperhidrosis (HH) and facial blushing (FB) is compensatory sweating (CS)...
  9. Wolosker N, Krutman M, Kauffman P, Paula R, Campos J, Puech Leao P. Effectiveness of oxybutynin for treatment of hyperhidrosis in overweight and obese patients. Rev Assoc Med Bras (1992). 2013;59:143-7 pubmed publisher
    Until the present moment, the lack of efficient therapeutic options available for hyperhidrosis treatment in obese patients has left this population without prospect of clinical or quality of life (QOL) improvements...
  10. Baumgartner F, Bertin S, Konecny J. Superiority of thoracoscopic sympathectomy over medical management for the palmoplantar subset of severe hyperhidrosis. Ann Vasc Surg. 2009;23:1-7 pubmed publisher
    Severe hyperhidrosis is a disabling disorder whose management is controversial. Medical treatment consists of topical aluminum chloride, oral anticholinergics, ionotophoresis, and botulinum toxin A (Botox) injections...
  11. Davarian S, Kalantari K, Rezasoltani A, Rahimi A. Effect and persistency of botulinum toxin iontophoresis in the treatment of palmar hyperhidrosis. Australas J Dermatol. 2008;49:75-9 pubmed publisher
    ..and persistence of the hypohidrosis induced by iontophoresis of botulinum toxin type A in patients with palmar hyperhidrosis. Eight patients with severe palmar hyperhidrosis participated in this study...
  12. Fiorelli A, D Aponte A, Canonico R, Palladino A, Vicidomini G, Limongelli F, et al. T2-T3 sympathectomy versus sympathicotomy for essential palmar hyperhidrosis: comparison of effects on cardio-respiratory function. Eur J Cardiothorac Surg. 2012;42:454-61 pubmed publisher
    ..A total of 45 patients with essential palmar hyperhidrosis were randomized into two groups: the conventional group (CG; 23 patients) and the simplified group (SG; 22 ..
  13. Kim W, Kil H, Yoon K, Yoon D, Lee J. Influence of T3 or T4 sympathicotomy for palmar hyperhidrosis. Am J Surg. 2010;199:166-9 pubmed publisher
    ..the efficacy of video-assisted thoracoscopic sympathicotomy at the T3 or T4 level in the treatment of palmar hyperhidrosis. Patients were operated on for palmar hyperhidrosis from April 2004 to December 2007, and classified as the T3 ..
  14. Miller D, Bryant A, Force S, Miller J. Effect of sympathectomy level on the incidence of compensatory hyperhidrosis after sympathectomy for palmar hyperhidrosis. J Thorac Cardiovasc Surg. 2009;138:581-5 pubmed publisher
    Palmar hyperhidrosis can be psychosocially devastating. Sympathectomy provides effective treatment. The most common side effect after sympathectomy is compensatory hyperhidrosis, which can be debilitating...
  15. Bellet J. Diagnosis and treatment of primary focal hyperhidrosis in children and adolescents. Semin Cutan Med Surg. 2010;29:121-6 pubmed publisher
    Primary focal hyperhidrosis is a disorder of excessive sweating that occurs in the axillae, palms, soles, and craniofacial region in amounts greater than needed for thermal regulation...
  16. Letada P, Landers J, Uebelhoer N, Shumaker P. Treatment of focal axillary hyperhidrosis using a long-pulsed Nd:YAG 1064 nm laser at hair reduction settings. J Drugs Dermatol. 2012;11:59-63 pubmed
    Axillary hyperhidrosis is a rather common idiopathic disorder of the eccrine sweat glands, which can interfere with daily activities and cause significant social distress...
  17. Cramer M, Jay O. Compensatory hyperhidrosis following thoracic sympathectomy: a biophysical rationale. Am J Physiol Regul Integr Comp Physiol. 2012;302:R352-6 pubmed publisher
    A side-effect of endoscopic thoracic sympathectomy (ETS) is compensatory hyperhidrosis (CH), characterized by excessive sweating from skin areas with intact sudomotor function...
  18. Kim D, Hong Y, Hwang J, Kim K, Lee D. Topographical considerations under video-scope guidance in the T3,4 levels sympathetic surgery. Eur J Cardiothorac Surg. 2008;33:786-9 pubmed publisher
    ..From June 2003 to January 2004, 44 patients with palmar hyperhidrosis underwent bilateral T3,4 ramicotomy via video-assisted thoracoscopic surgery...
  19. Cetindag I, Boley T, Webb K, Hazelrigg S. Long-term results and quality-of-life measures in the management of hyperhidrosis. Thorac Surg Clin. 2008;18:217-22 pubmed publisher
    Primary focal hyperhidrosis has a significant, negative impact on quality of life, causing impairments in social, physical, leisure, and occupational activities...
  20. De Campos J, Wolosker N, Yazbek G, Munia M, Kauffman P, Puech Leao P, et al. Comparison of pain severity following video-assisted thoracoscopic sympathectomy: electric versus harmonic scalpels. Interact Cardiovasc Thorac Surg. 2010;10:919-22 pubmed publisher
    ..in a group of 1515 patients who underwent video-assisted thoracoscopic sympathectomy (VATS) to treat primary hyperhidrosis, among whom 929 were treated using electric scalpels and 586 using harmonic scalpels...
  21. Wolosker N, Yazbek G, De Campos J, Munia M, Kauffman P, Jatene F, et al. Quality of life before surgery is a predictive factor for satisfaction among patients undergoing sympathectomy to treat hyperhidrosis. J Vasc Surg. 2010;51:1190-4 pubmed publisher
    ..a group of 1167 patients who underwent video-assisted thoracoscopic sympathectomy (VATS) to treat primary hyperhidrosis, as compared with the presurgical QOL...
  22. Araújo C, Azevedo I, Ferreira M, Ferreira H, Dantas J, Medeiros A. Compensatory sweating after thoracoscopic sympathectomy: characteristics, prevalence and influence on patient satisfaction. J Bras Pneumol. 2009;35:213-20 pubmed
    ..From 2000 to 2002, 80 patients (53 females and 27 males) underwent thoracoscopic sympathectomy to treat hyperhidrosis. Patient ages ranged from 12 to 56 years, and the mean post-operative follow-up period was 42.51 +/- 5...
  23. Wolosker N, De Campos J, Kauffman P, Yazbek G, Neves S, Puech Leao P. Use of oxybutynin for treating plantar hyperhidrosis. Int J Dermatol. 2013;52:620-3 pubmed publisher
    ..the effectiveness and patient satisfaction with the use of oxybutynin at low doses for treating plantar hyperhidrosis. From January 2007 to December 2010, 35 consecutive patients with plantar hyperhidrosis were treated with ..
  24. Sugimura H, Spratt E, Compeau C, Kattail D, Shargall Y. Thoracoscopic sympathetic clipping for hyperhidrosis: long-term results and reversibility. J Thorac Cardiovasc Surg. 2009;137:1370-6; discussion 1376-7 pubmed publisher
    ..June 1998 and March 2006, 727 patients undergoing bilateral endoscopic thoracic sympathetic clipping for hyperhidrosis or facial blushing were prospectively followed for postoperative satisfaction and subjective compensatory ..
  25. Bachmann K, Standl N, Kaifi J, Busch P, Winkler E, Mann O, et al. Thoracoscopic sympathectomy for palmar and axillary hyperhidrosis: four-year outcome and quality of life after bilateral 5-mm dual port approach. Surg Endosc. 2009;23:1587-93 pubmed publisher
    During recent years, thoracoscopic sympathectomy has been the standard treatment for hyperhidrosis. Different surgical techniques have been described without proving their advantages compared with other procedures...
  26. Kim W, Yoon K, Kil H, Yoon D. Chemical lumbar sympathetic block in the treatment of plantar hyperhidrosis: a study of 69 patients. Dermatol Surg. 2008;34:1340-5 pubmed publisher
    Plantar hyperhidrosis is a distressing problem that can affect a patient's quality of life. Although various conservative modalities have been suggested, severe plantar hyperhidrosis is often not sufficiently treated...
  27. Latif M, Afthinos J, Connery C, Perin N, Bhora F, Chwajol M, et al. Robotic intercostal nerve graft for reversal of thoracic sympathectomy: a large animal feasibility model. Int J Med Robot. 2008;4:258-62 pubmed publisher
    ..The robotic device allows the principles of neural microsurgery to be maintained and provides a minimally invasive option for reconstruction of the sympathetic chain. ..
  28. Cruz J, Fonseca M, Pinto F, Oliveira A, Carvalho L. Cardiopulmonary effects following endoscopic thoracic sympathectomy for primary hyperhidrosis. Eur J Cardiothorac Surg. 2009;36:491-6 pubmed publisher
    Endoscopic thoracic sympathectomy (ETS) is performed for the treatment of primary hyperhidrosis (PH). The second and third sympathetic thoracic ganglions excised in ETS also innervate the heart and lung...
  29. Walling H. Primary hyperhidrosis increases the risk of cutaneous infection: a case-control study of 387 patients. J Am Acad Dermatol. 2009;61:242-6 pubmed publisher
    Although primary hyperhidrosis (PHH) has been frequently associated with diminished quality of life, the medical consequences of the condition are less well studied...
  30. Ibrahim M, Menna C, Andreetti C, Ciccone A, D Andrilli A, Maurizi G, et al. Two-stage unilateral versus one-stage bilateral single-port sympathectomy for palmar and axillary hyperhidrosis. Interact Cardiovasc Thorac Surg. 2013;16:834-8 pubmed publisher
    Video-assisted thoracoscopic sympathectomy is currently the best treatment for palmar and axillary hyperhidrosis. It can be performed through either one or two stages of surgery...
  31. Rieger R, Loureiro M, Pedevilla S, de Oliveira R. Endoscopic lumbar sympathectomy following thoracic sympathectomy in patients with palmoplantar hyperhidrosis. World J Surg. 2011;35:49-53 pubmed publisher
    Palmoplantar hyperhidrosis is a common disease that leads to significant psychosocial strain for the affected person...
  32. Bouma W, Klinkenberg T, Mariani M. Bilateral single-port thoracoscopic sympathectomy with the VasoView device in the treatment of palmar and axillary hyperhidrosis. Interact Cardiovasc Thorac Surg. 2011;12:106-9 pubmed publisher
    Primary or essential hyperhidrosis is a disorder characterized by excessive sweating beyond physiological needs. It is a common disease (with an incidence of up to 2.8%) that causes intense discomfort for patients...
  33. Del Sorbo F, Brancati F, De Joanna G, Valente E, Lauria G, Albanese A. Primary focal hyperhidrosis in a new family not linked to known loci. Dermatology. 2011;223:335-42 pubmed publisher
    Primary focal hyperhidrosis (PFH) is a disabling disorder. A first locus has been mapped in families with only palmar involvement, raising the question whether other unknown genes are responsible for more diffuse phenotypes.
  34. Walling H. Systemic therapy for primary hyperhidrosis: a retrospective study of 59 patients treated with glycopyrrolate or clonidine. J Am Acad Dermatol. 2012;66:387-92 pubmed publisher
    Data regarding systemic medications in the management of hyperhidrosis (HH) are limited.
  35. Ambrogi V, Campione E, Mineo D, Paterno E, Pompeo E, Mineo T. Bilateral thoracoscopic T2 to T3 sympathectomy versus botulinum injection in palmar hyperhidrosis. Ann Thorac Surg. 2009;88:238-45 pubmed publisher
    ..injection of botulinum toxin-A are presently the most effective modalities in the treatment of primary palmar hyperhidrosis. In this study we evaluated comparative merits of the two therapies...
  36. Skiveren J, Kjaerby E, Nordahl Larsen H. Cooling by frozen gel pack as pain relief during treatment of axillary hyperhidrosis with botulinum toxin a injections. Acta Derm Venereol. 2008;88:366-9 pubmed publisher
    Botulinum toxin A injection is a well-described efficacious treatment for axillary hyperhidrosis. Although considered a safe treatment, many patients experience pain during injections...
  37. Doft M, Kasten J, Ascherman J. Treatment of axillary hyperhidrosis with botulinum toxin: a single surgeon's experience with 53 consecutive patients. Aesthetic Plast Surg. 2011;35:1079-86 pubmed publisher
    Axillary hyperhidrosis is a debilitating disease that affects the social and occupational lives of many Americans. It can be treated with subdermal injections of botulinum toxin...
  38. Walling H, Swick B. Treatment options for hyperhidrosis. Am J Clin Dermatol. 2011;12:285-95 pubmed publisher
    b>Hyperhidrosis is a disorder of excessive sweating beyond what is expected for thermoregulatory needs and environmental conditions...
  39. Munia M, Wolosker N, Kaufmann P, de Campos J, Puech Leao P. Sustained benefit lasting one year from T4 instead of T3-T4 sympathectomy for isolated axillary hyperhidrosis. Clinics (Sao Paulo). 2008;63:771-4 pubmed
    Level T4 video-assisted thoracoscopic sympathectomy proved superior to T3-T4 treatment for controlling axillary hyperhidrosis at the initial and six-month follow-ups of these patients...
  40. Garcia Franco C, Espana A. [Usefulness of bilateral sympathectomy using video-assisted thorascopic surgery in the treatment of essential hyperhidrosis]. Actas Dermosifiliogr. 2008;99:523-7 pubmed
    Essential, idiopathic, or primary hyperhidrosis is defined as excessive sweating in certain areas of the body due to factors unrelated to other disease...
  41. Santana Rodríguez N, Clavo Varas B, Ponce González M, Jarabo Sarceda J, Pérez Alonso D, Ruíz Caballero J, et al. Primary frontal hyperhidrosis successfully treated with low doses of botulinum toxin A as a useful alternative to surgical treatment. J Dermatolog Treat. 2012;23:49-51 pubmed publisher
    Frontal hyperhidrosis appears to be a special and rare form of focal hyperhidrosis. These patients may suffer greatly from the condition so an efficient treatment is highly demanded...
  42. Iwase S, Ikeda T, Kitazawa H, Hakusui S, Sugenoya J, Mano T. Altered response in cutaneous sympathetic outflow to mental and thermal stimuli in primary palmoplantar hyperhidrosis. J Auton Nerv Syst. 1997;64:65-73 pubmed
    ..by microneurography at an ambient temperature of 25 degrees C in five subjects with primary palmoplantar hyperhidrosis. The resting of the tibial SSNA innervating the sole (glabrous skin) increased moderately (36.5 +/- 1...
  43. Lakraj A, Moghimi N, Jabbari B. Hyperhidrosis: anatomy, pathophysiology and treatment with emphasis on the role of botulinum toxins. Toxins (Basel). 2013;5:821-40 pubmed publisher
    Clinical features, anatomy and physiology of hyperhidrosis are presented with a review of the world literature on treatment. Level of drug efficacy is defined according to the guidelines of the American Academy of Neurology...
  44. Wolosker N, De Campos J, Kauffman P, Neves S, Munia M, Bisceglijatene F, et al. The use of oxybutynin for treating axillary hyperhidrosis. Ann Vasc Surg. 2011;25:1057-62 pubmed publisher
    To evaluate the effectiveness and patient satisfaction with the use of oxybutynin for treating axillary hyperhidrosis in a large series of patients. One hundred two patients with axillary hyperhidrosis were treated with oxybutynin...
  45. Atkinson J, Fode Thomas N, Fealey R, Eisenach J, Goerss S. Endoscopic transthoracic limited sympathotomy for palmar-plantar hyperhidrosis: outcomes and complications during a 10-year period. Mayo Clin Proc. 2011;86:721-9 pubmed publisher
    To review surgical results of endoscopic transthoracic limited sympathotomy for palmar-plantar hyperhidrosis during the past decade.
  46. Currie A, Evans J, Thomas P. An analysis of the natural course of compensatory sweating following thoracoscopic sympathectomy. Int J Surg. 2011;9:437-9 pubmed publisher
    ..Thoracoscopic sympathectomy is effective in the treatment of hyperhydrosis. However compensatory sweating seems unavoidable and infrequently improves with time. Patients need to be carefully counselled before committing to surgery. ..
  47. Coelho M, Kondo W, Stunitz L, Branco Filho A, Branco A. Bilateral retroperitoneoscopic lumbar sympathectomy by unilateral access for plantar hyperhidrosis in women. J Laparoendosc Adv Surg Tech A. 2010;20:1-6 pubmed publisher
    Primary focal hyperhidrosis is a disorder of excessive, bilateral, and relatively symmetric sweating occurring in the axillae, palms, soles, or craniofacial region...
  48. Chen Y, Ye W, Yang W, Shi L, Guo X, Xu Z, et al. Uniportal versus biportal video-assisted thoracoscopic sympathectomy for palmar hyperhidrosis. Chin Med J (Engl). 2009;122:1525-8 pubmed
    ..outcomes of using a single port and two ports to perform video-assisted thoracoscopic sympathectomy for palmar hyperhidrosis. Between April 2006 and February 2008, 20 cases underwent video-assisted thoracoscopic sympathectomy through ..
  49. Chwajol M, Barrenechea I, Chakraborty S, Lesser J, Connery C, Perin N. Impact of compensatory hyperhidrosis on patient satisfaction after endoscopic thoracic sympathectomy. Neurosurgery. 2009;64:511-8; discussion 518 pubmed publisher
    Endoscopic thoracic sympathectomy (ETS) remains the definitive treatment for primary focal hyperhidrosis. Compensatory hyperhidrosis (CH) is a significant drawback of ETS...
  50. Kocyigit P, Akay B, Saral S, Akbostanci C, Bostanci S. Unilateral hyperhidrosis with accompanying contralateral anhidrosis. Clin Exp Dermatol. 2009;34:e544-6 pubmed publisher
    Localized unilateral or segmental hyperhidrosis is a rare form of increased sweat production of unknown origin...
  51. Wolosker N, Ishy A, Yazbek G, Campos J, Kauffman P, Puech Leao P, et al. Objective evaluation of plantar hyperhidrosis after sympathectomy. Clinics (Sao Paulo). 2013;68:311-5 pubmed
    ..blindly, and objectively investigate how surgery affects plantar sudoresis in patients with palmar and plantar hyperhidrosis over a one-year period using a sudorometer (VapoMeter)...
  52. Li X, Tu Y, Lin M, Lai F, Chen J, Dai Z. Endoscopic thoracic sympathectomy for palmar hyperhidrosis: a randomized control trial comparing T3 and T2-4 ablation. Ann Thorac Surg. 2008;85:1747-51 pubmed publisher
    ..is a major and troublesome complication noted frequently after sympathectomy in patients with primary palmar hyperhidrosis. This randomized clinical trial was projected to measure the impact of limited denervation on compensatory ..
  53. Gulec A. Dilution of botulinum toxin A in lidocaine vs. in normal saline for the treatment of primary axillary hyperhidrosis: a double-blind, randomized, comparative preliminary study. J Eur Acad Dermatol Venereol. 2012;26:314-8 pubmed publisher
    Botulinum toxin A (BTX-A) is an effective and safe treatment modality for primary axillary hyperhidrosis. However, some patients experience considerable pain during injections.