WARNING: The Embarrassing Bodies website contains images of an explicit medical nature and nudity in a medical context.

Video

Voiceover:
Earlier, Gemma came to the clinic to show Dr Pixie her excessively sweaty hands.

Dr Pixie:
It…it’s dripping! It’s like you’ve put your hands into…into water, actually.

Gemma:
Yeah.

Dr Pixie:
Or you’ve been to the loo and you’ve washed your hands but you haven’t dried them.

Gemma:
Yeah.

Voiceover:
Although there are other solutions to this problem, because Gemma’s case was so severe, her only option was to undergo a surgical procedure. She has come to Wythenshawe Hospital to see vascular expert Mr Mo Baguneid.

Mr Baguneid:
The operation we’re considering here is called endoscopic thoracic sympathectomy. Essentially it involves, uh, dividing a small nerve in the chest, which really is very effective in reducing sweating in the hands. The problem is, about one in five also experience sweating elsewhere, and that’s what we call compensatory sweating. And that can be in the, in the groin, it can be in the belly, it can be in the back. What I tend to suggest in these cases is that your dominant hand, the one that you shake people’s hands with…

Gemma:
Yeah.

Mr Baguneid:
...if we treat that side first, and see the effect you have, and the amount of compensatory sweating you get, from doing both together.

Gemma:
Yeah, I definitely want to do that, I’d rather just do the one first.

Mr Baguneid:
Gemma’s got a condition called hyperhidrosis, basically excessive sweating. Now, we’re all meant to sweat—I mean if you run, you’d expect to sweat. If the excessive sweating occurs at a time when the stimulus…in other words, somebody gets anxious and they sweat very heavily, well, that’s hyperhidrosis, that’s the condition she has at the moment.

Voiceover:
Having taken the decision to go ahead with the operation, the first task for the team is to gain access to the sympathetic nerve in the chest cavity. They start by deflating the right-hand lung.

Mr Baguneid:
We’ll now clamp the right side, and release the lung to activate pressure.

Voiceover:
This is a crucial part, because if Gemma can’t support her breathing on one lung, the operation cannot be performed. Mr Baguneid then cuts a hole under the armpit, and places a port so he can insert a small camera.

Mr Baguneid:
This camera goes in, we’ll see a little bit of lung tissue there. And just above, we’re now inside the lung cavity. And in fact, you can just probably make out, these are, this is the nerve, that white structure next to the vein, the vein being the big blue structure next to it here, on the side. That’s the nerve that we actually need to divide.

Voiceover:
Once the nerve is identified, it is cauterised in two places to stop it working.

Mr Baguneid:
So that’s the procedure complete. What we need to see now is that the lung needs to completely re-expand to fill the cavity up. And you’ll see it now.

Voiceover:
Once the lung is re-inflated, all Gemma needs is a few stitches. Gemma should see an instant result, but will have to check for any compensatory sweating.

Voiceover:
Two weeks later, Gemma’s back to tell Dr Pixie whether she’ll have the other hand done.

Dr Pixie:
So how did you get on with the operation?

Gemma:
Fantastic! Really happy about it, yeah, it’s great.

Dr Pixie:
How…one side or both sides, did you just get one side done?

Gemma:
Just one side done, yeah.

Dr Pixie:
Okay, so tell me what happened.

Gemma:
Um, well, I just went in, it was dead straightforward, tiny little cut, um, under my arm. And basically I woke up and I had a dry hand, it was just fantastic.

Dr Pixie:
Brilliant, can I have a look?

Gemma:
Yup.

Dr Pixie:
That is amazing. It’s so dry. And then this, which has, the one that hasn’t been done is so…wet.

Gemma:
Yup.

Dr Pixie:
Before you had the operation, what I was worried was about compensatory hyperhidrosis.

Gemma:
Yeah, yeah.

Dr Pixie:
Which basically means you sweat elsewhere. Have you had any problems with that, on your face, your back or anything?

Gemma:
No, nothing at all.

Dr Pixie:
Nothing at all.

Gemma:
No, it’s been great.

Dr Pixie:
So are you going to have the other one done?

Gemma:
Yes, definitely, yeah.

Dr Pixie:
Brilliant. And when we met, you were having a really difficult time with your baby, trying to change the baby and everything because of this sweating. Has…has it made a difference?

Gemma:
Yeah, it has made a difference, and it’s just become so much easier, everything. It’s just fantastic, it’s just changed my life completely, and I can imagine that when this one’s done, it’s just going to be great.

Dr Pixie:
Superb.

Gemma:
So, I’m really happy, yeah.

Dr Pixie:
Gemma, lovely to see you back again. Do please keep in touch with me with regard to the other hand.

Gemma:
I will do, thank you very much, cheers!

Dr Pixie:
You’re welcome, it’s been a pleasure, bye-bye.

Gemma:
Bye.

Read the video transcript

Gemma came to see Dr Pixie with hands that were so sweaty she had to wear gloves to hold her baby in case she dropped her. After seeing a specialist, Gemma decided to undergo surgery to ease the sweating. The nature of this surgery means that sometimes the sweat is directed elsewhere on the body so Gemma decides to only get one hand fixed at a time to see if the sweat will find a new way out. Returning to the surgery Gemma noted the success of the procedure and now plans to have a further op to sort out her left hand too.

Patient Name: Gemma Hudson
Condition: Sweaty Hands
Specialist: Mr Mo Baguneid, Consultant Vascular Surgeon
Hospital: South Manchester University Hospital
Length of procedure: Approx 1 hour

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i have HH its the worst on my hands but i also get it on my underarms,feet and neck. its so embarrassing especially when you're my age (18) it makes you really self conscious, its awful. I've tried all the antiperspirants, they didn't work on me, i have tried ionphoresis as well which also didn't work on me. Im now on a six month waiting list for botox with surgery being my next option but im worried if i get the surgery because i get it in other areas will it make the sweating in those areas worse





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HH is hyperhydrosisi, a technical name for excessive sweating.

Hyperhydrosis

I have had HH on my palms and feet since I was 6..I am 35 now. I first noticed it after I accidentally burnt my hands with a hot iron.I cannot control the sweating. I always look nervous. It is embarrassing and I can't shake hands without people looking at me with disgust. My sweaty feet ruin my shoes and my feet stink so bad it is embarrassing. I have tried iontophoresis. it didn't work.I tried Odaban..no help at all.. Tried some specially prescribed ( by dermatology consultant) formulations/creams. They didn't work. Please what are GPs allowed to prescribe in the UK? I heard of robinul tablets..and beta blockers.. do they work? Can GPs prescribe them? I am desperate. I have no confidence. i don't know how to explain it to my kids when i can't hold their hands..Sweat is dripping all over the key board as i speak. The quality of life i live is so diminished. None of my family members see to understand how bad i feel...Help!!!





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Hi, I've being actually suffering from the same problem since I was a young boy and now I'm 20 years old and I still have the problem. When I saw this show I really got interested and I wanted to do the surgery as soon as possible, but the problem is that I don't live in UK, I live in Sweden. And I don't know much money will it cost me to do the surgery, so would someone please help with that? I really need help. Thanks





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Hi I really feel for those with HH. Mine kicked in greatly at puberty - that's over 30 years ago. My teenage daughter is now starting too. I'd like to share my advice on how to manage this condition in the hope that some of you will find it useful. My condition has been severe sweating of the hands, feet and groin/backs of thighs. My underarms sweated probably a bit more than the avarage bod too. First off, lots of teenagers have clammy sweaty hands, so you may just fit into this category at this stage. However, my daughter is so surprised when she shares her sweaty problem with friends, they also claim the same but I guess if you're reading this and you can't hold things, your hands soak through paper, drip etc... you know it's more likely HH than just teenage hormones. To start with try one of the over-the-counter strong antiperspirants such as Driclor, Anhydrol Forte or Odaban. Personally my daughter and I found Driclor was most effective but stings after a few days usage (causing our delicate skin contact dermatitis) and the Odaban the least irritant but less effective (good for sprin/summer/aut when hands slightly less wet). Don't ever shave armpits just before and use-it stings like hell. Make sure you are as dry as poss (not easy in the heat I know!) before application. Try the stronger "sure" and "dove" antiperspirants from chemists for underarms for daytime use (£5 each!). If this is not sufficient, go and see your GP to ask for a Dermatology referral-the next thing to try is iontopheresis. You may need to fight for this depending on area (we did). You want a regime which uses the machine for approx 10 minutes on each hand (foot/armpit etc..) and then another 10 minutes reversing the current, for each treatment but it must be on a regime where you have alternate day treatments in the first week (=3) then 2 treatments in the second week and then 1 each week for the next two weeks (or a very similar routine, 7 treatments in 4 weeks) to have best chance of working. It doesn't hurt, it's a bit tingly, an odd sensation and you may need Vaseline or similar barrier around the edges of hands (feet etc..) not fully immersed to avoid irritation. Your local hospital should be able to arrange a trial to see if it works...I then gather its up to you to then purchase machine (madness I know, especially for children!)- but hospital can advise. Machines are roughly £400 but I think it's trial and error to work out how often you'll need to top-up your treatments to keep you dry but I'm sure you can watch tv whilst keeping the machine going-no major inconvenience-especially if you're dripping. If this doesn't help, or not enough, the dermatologist can prescribe medicines to help. My daughter has just started trying Propantheline Bromide. The iontopheresis did help her hands (not her feet though) but as her sweating is more widespread she wants to try the drug treatment. It's too early to give a result but she can feel a slight effect without much side effect and has been advised to slightly raise the dosage-will keep you posted. Your GP can also prescribe this but may hesitate as its "off license" for this use (only means that it's supposed to be prescribed for another condition not HH! But this I feel is a mere formality, they know it can work). There are other tablets too, refer to dermatologist for most suitable for you. Botox injections may help with underarm sweating but I have yet to find a doctor to do hands/feet even when they advertise on website. Botox may be available on NHS so try before paying out. Botox can provide relief for 6-9 months before more treatment is necessary...so maybe good to get through the warmest parts of the year perhaps? Finally, if none of the above hits the spot, you may want to consider surgery. There is some new surgery to remove sweat glands, by vacuuming them up, I can't confess to knowing about this new procedure so will leave it to you to investigate with your GP. However, there is Endoscopic Thoracic Sympathectomy surgery to consider. This should only really be considered for severe hand sweating. Although it is generally completely successful in stopping hand sweating there are risks. Theres a small risk of Horners Syndrome (1%- google it) but also of compensatory sweating-where you start sweating elsewhere-in some cases profusely. You will see many scare stories on web of this surgery, a lot of this was several years ago when the technique was in its infancy and I'm sure the effects for victims are hard to deal with and my heart goes out to them. You should ensure that your surgeon plans to cut the nerves no more than at ganglia 3 and 4 and no higher (eg 1,2). There is research into just doing cut at 4 as this seems to reduce risk of compensatory effect further. Check your surgeon is fully experienced...do your research and discuss with your GP!!! It is still risky but I decided to take the risk, a very carefully calculated one. I have had incredible results but I am not advocating the surgery-you have to weigh it all up for yourself-but it is an option. I do have some compensatory sweating on torso and front of thighs but its not particularly bothersome, certainly in comparison to before. My feet, underarms and back of thighs have also improved as a bonus, but this should not be expected. The GP said to my daughter when we first consulted him 'well it's nothing life threatening' - how wrong he is! I couldn't explain it in front of my daughter as I don't wish to project my experience of HH onto her, but I have felt suicidal several times because of this condition and the effect its had on my life (choice of career, relationships, professional and social interactions, sports) but you have to develop coping mechanisms both practical and emotional ones in your armoury against this condition. If you are feeling really down please try to speak to someone about it (parent, GP, teacher, responsible friend). Over the last 3 decades I have seen more treatments developed to cope with HH and I'm sure there will be even better ones to come! Best wishes in your endeavours.





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No one without this condition will understand the emotional torment that it causes. Everyday of my life I wake up debating on wether to kill myself, it truely ruins everything. Social/professional relationships, everything. I don't want to go on no more.





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It's really not that bad! i've had it all my life adn through school and college its horrible, shaking peoples hands now, not being able to use fingerprint machines as mine cant be read cause of the sweating. You can have treament so go see youre doctor to try out some procedures! nothing worked for me so now im considering surgery.

don't lose hope you're not alone & there's some people have it way worse

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Hello my name is Akram .my hands sweat a lot. So do my feet and armpits. Hands are the worst. The sweat drips and I always hold a tissue. It stared at school, when I was 6 or 7 and found it difficult to write and hold a pen. I am 28 now and the problem doesn't go away. It gets worse when I am stressed or having a bad day. I visited a lot of doctors and they always do my blood test just in case there is something wrong with me but the results are always good. I tried deodorants but they don't help. I also tried botox. I am finding it more and more difficult to deal with it. Often very simple things are difficult like doing my hair or make up or writing. I am always dreading shaking people's hands. My hands are not just clammy. They often looked like I just washed them and didn't dry them. Without holding a tissue, sweat would just drip. Feet can be as bad but I can deal with that. Its hands that make me so embarrassed every day. I really need some help.please can someone help me.





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I have had hyperhidrosis of the hands and feet since I was born in Australia. I'm now 35. It was so bad it would soak my papers I'd be working on, was teased terribly at school, soak the keyboard at work and dreaded meetings of mere handshakes. I had years of social anxiety and depression that stemmed from this so I understand all your feelings on this terrible ailment. I had the ETS operation at my neck at 12 years of age for my right hand risking the face paralysis and all was successful for about 5 years until the nerve grew back. At age 28 I had the ETS operation done again thru keyhole surgery for both hands and it has been a great success. I've had compensatory sweating in the torso which is bearable and my feet more than ever. But that is controllable wearing socks and washable innersoles. It is worth being able to touch my friends/family and hold my new baby. Unfortunately I've realised this condition is hereditary and my newborn baby has terrible sweaty hands and feet that they pour onto the floor. Worse than what mine was as an infant. It makes me want to cry that I have given her this and want to know how young is too young to do the ETS operation safely. She is 6 months old and I don't want her to start school without getting this op done.





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Hi Michelle. It sounds like you've been through an awful lot with this condition (which makes forums such as this so great in having so many people who can relate to each other eh). Firstly I should say that I am not a parent. However, if I was in your situation I would not ever consider having any of these operations(whether ETS or lumbar sympathectomy) for your baby / child. In my opinion these operations are barbaric and ruin so many lives from what I've read over the years and from personal experience. As someone pointed out elsewhere, think about it - everyone has these nerves (including 'normal' people who don't have hyperhidrosis) like us. It's just that ours are overactive. The process therefore is surely to work with the nerves rather than destory them, because as I have found the hard way, they serve so many more functions than just sweating in the body. The sympathectic nerves are linked with so many things such as heart rate, and so to destory them in this way again is just wrong in my opinion. Back to your baby, like I said if it was me I would keep him or her a million miles away from surgery through their lifetime, and instead get the best you possibly can from non-surgical treatments. I'm convinced that for someone with palm and foot hyperhidrosis, a combination of iontophoresis, a prescription-strength anti-perspirant (such as Odaban, Driclor etc) and possibly some counselling for the years of social anxiety, depression etc (something I really can relate to) would solve most sufferers problems. Iontophoresis, from what I've read, sounds like a superb treatment, and I only wish that I had been told about it by a supposed 'specialist' at the local hospital that I visited. It has become very popular in the UK and US, but may be available in Australia too. If not, there are companies who I bet ship worldwide. I would definitely look into this for your child when he/she is a few years old (I'm not certain but it's probably not recommended for a very young baby e.g. because while it is not said to be painful for adults the tingling might be painful for a baby). Apart from this there are also oral / topical medications such as robinul, so there really are plenty of alternatives to surgery. Best wishes and take care. Ewan

My hands sweat a lot. So do my feet and armpits. Hands are the worst. The sweat drips and I always hold a tissue. It stared at school, when I was 6 or 7 and found it difficult to write and hold a pen. I am 28 now and the problem doesn't go away. It gets worse when I am stressed or having a bad day. I visited a lot of doctors and they always do my blood test just in case there is something wrong with me but the results are always good. I tried deodorants but they don't help. I also tried botox. I am finding it more and more difficult to deal with it. Often very simple things are difficult like doing my hair or make up or writing. I am always dreading shaking people's hands. My hands are not just clammy. They often looked like I just washed them and didn't dry them. Without holding a tissue, sweat would just drip. Feet can be as bad but I can deal with that. Its hands that make me so embarrassed every day. I really need some help





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Hi Gosia. I'm sorry to hear that you've had to go through this for so many years. I suffered with terribly sweaty hands and feet for years too though, so I really can understand what you're going through. If I was you, I would learn from the mistakes of people such as myself and stay well clear of Endoscopic Thoracic Sympathectomy (and any types of operations). For years at school, college etc I felt that my life could not get any worse than having dripping hands and feet. However, after 11 years of horrendous surgery side-effects I can safely say that my life before the operations was 1000x better and happier than it is now. Therefore I would stay completely away from operations, and instead pursue iontophoresis. If you ask your GP about this he/she should be able to refer you to a local dermatology clinic to have it done. From what I've seen/read it consists of 7 treatments spread over a month (20-30 mins each), and is usually effective for 70%-80% of patients. This is for hand and foot sweating. If you found that it did not get your hands and feet dry enough, there are also prescription-strength anti-perspirants available like Odaban, Driclor, Anhydrol Forte etc (when you said anti-perspirants I didn't know if you meant the likes of these or just Sure, Rightguard etc). Odaban seems the most effective anti-perspirant for underarms, and is available online if you can't find it in Boots etc. So this is what I would do personally. The only other thing I can say is please try to be as positive as you can. You've got so much life ahead of you and I really believe that the treatments I have mentioned (and there are alo medications like robinul too) could make a positive difference to your life, and trust me, things can always be worse (due to the operations I now sweat horribly through my back, stomach, sides, chest and legs). There are so many little tricks with these treatments too, for example with the likes of Odaban and Driclor (you apply them at night before going to sleep) you can even increase their effect further by wearing plastic gloves like you get from a petrol station. I know this sounds bizare, but it is something the maker of Odaban works so there must be some logic/science behind it! Anyway, please stay positive and don't ever see surgery as the only way out because it isn't. There's so much you can do to work with your symptoms, and like I said you've got so much life to live, and I'm sure you can get some positive results with non-surgical techniques. Take care. Ewan

Hi I'm Mitch I'm suffering hyperhidrosis for my feet and hands starting when I was 14 and now I'm 25 years old.many times I think I will treat to end my life it because of this condition.because of this condition I can't finish my studying I just finish high school.i remember when I was high school everyday I'm crying because my classmate laughing me because of my sweaty and if I'm finish my graduation I'm always at the house.my shoes smell so bad I can't shake my hands to the other. I scared going outside because I keep my secret for about my hyperhidrosis,I don't have bf,I don't have friends,if I singing in the house my neighbor asking my mother if who sing the song and my mother tell them that's my daughter singing and everybody say to my mother I'm a frofessional singer.my dream is to ba come a frofessional singer but for my condition I can't do.and I'm a girl I want a family but I scared because maybe my baby take my problem and I don't like she fell so bad like me.i lives in the phillipines my mother is only a farmer my fathers too.i want gotto to the dermatologist for consult my problem but my family no have money.sometimes I looking outside from my room I'm to jealous to the other girls have a normal life..please somebody help me..my wish before I'm die I lives with a normal young girls like the others

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Just a 6 month update from an Endoscopic Thoracic Sympathectomy / Lumbar Sympathectomy victim (sorry for sounding facetious but I don't know how else to put it!). Everything still as it was in June really. My hands and feet are still stupidly dry (e.g. I did 45 mins on a treadmill earlier - not the slightest bit of sweat from my left foot and very little from my right, or my palms). Face, forehead, scalp, neck and underarms all extremely dry too. Other side-effects like severe sweating on the back, stomach, chest and legs still the same. Saw a neurologist in the summer, seeing him again in the New Year but hold out very little hope. For anyone still considering either of these operations please, please do not do it. The side-effects and dramatic reduction in quality of life (I feel) make these ops just simply not worth it. Basically I see me years pre-operations as my life, and post-operations as just an existance. For me the pleasure of having mostly dry hands and feet is not worth the horrendous side-effects. Please people follow the non-surgical route and don't make the same terrible mistakes that myself and others were led to by incompetence and negligence. Oh and if any doctor wishes to do some stem-cell studies I would happily like to volunteer as a guinea pig! lol. :D





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I am only 14 and my hands get sweaty all the time and its embarrassing because people are starting to notice at school. My hands look like ive just came out the bath as they go all wrinkly and are soaking with sweat and when they dry my skin goes all dry and breaks which makes it look flaky so i put hand creme on but it just looks like my hands are even more sweaty. I was wondering if you can help me or give me some advice on how i could reduce the amount of sweat my hands produce or even find a way to stop it, thanks!





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