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Hyperhidrosis of the Feet (Plantar Hyperhidrosis) and Endoscopic Lumbar Sympathectomy

By: Hratch Karamanoukian, MD and Raffy Karamanoukian, MD

August 12, 2008

Is Treatment for Hyperhidrosis of the Feet Safe ? Plantar Hyperhidrosis and Lumbar Sympathectomy (ELS or LES) – Update 2008 -
  • A Brazilian study looked at the efficacy of Lumbar Endoscopic Sympathectomy (LES or ELS) for hyperhidrosis of the feet (plantar hyperhidrosis) in women. The study authored by Dr. Loureiro and colleagues from the Programa de Pós-Graduação em Ciências - Cirurgia Torácica e Cardiovascular, Faculdade de Medicina, Universidade de São Paulo, São Paulo investigated the utility of performing this procedure in women who continued to have hyperhidrosis of the feet after they had ETS (Endoscopic thoracic Sympathectomy).
  • It should be noted that ETS performed for palmar and/or axillary hyperhidrosis often cures hyperhidrosis of the feet in approximately 40% of 60% of patients in the published literature. The authors in this study enrolled patients who had persistent sweating in the feet after ETS.
  • Thirty female patients were enrolled to receive ELS or no intervention at all. They showed that patients who had ELS had significant improvement in their quality of life indicators (QOL) and lower values of foot sweat. However, 20% of patients had prolonged pain after this procedure.
  • The study conclusions were that “endoscopic retroperitoneal lumbar sympathectomy (ELS) diminishes plantar sweat and improves the quality of life of women with plantar hyperhidrosis. However, about half of the patients develop increased compensatory hyperhidrosis in other areas of the body”.
  • Dr. Karamanoukian note – This study indicates to me that we have not reached the tipping point in terms of success rates with ELS and therefore I do not recommend this procedure for plantar hyperhidrosis as of this writing in 2008.
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For more information about hyperhidrosis (excessive sweating) , as well as surgical and non-surgical hyperhidrosis treatment options, contact Dr. Karamanoukian at The Center for Excessive Sweating, a National Center of Excellence for Hyperhidrosis Treatment by email or by phone at (716) 839-3638.

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