Hyperhidrosis of the hands and feet, also known as palmar and plantar sweating, results from overactivity of the sympathetic nervous system. Endoscopic thoracic sympathectomy is currently considered a definitive, minimally invasive, and highly effective surgical treatment for this condition. However, choosing the right time and age for surgery is a significant concern for many patients and their families.

Endoscopic thoracic sympathectomy can be performed across various age groups, from adolescents to adults and middle-aged individuals, depending on the specific medical condition and fitness for anesthesia. Nevertheless, intervention for each age group requires specific considerations.

Adolescence and puberty are periods of significant endocrine changes, nervous system development, and organ maturation in children. Doctors carefully weigh the benefits against the risks, assess the impact of the condition on academics, daily activities, and psychological well-being, and provide comprehensive counseling on potential complications.

For adults, surgery is typically considered when conservative treatments are ineffective, as patients can make their own treatment decisions and adhere well to post-operative follow-up. However, age is not the sole factor. Surgical indications must be individualized based on the disease severity, health status, and patient preferences.

Master, Doctor, Level 1 Specialist Phan Vu Hong Hai (left) and the surgical team perform endoscopic surgery to treat hyperhidrosis for a patient. Illustration: Tam Anh General Hospital.

While awaiting surgery, parents can help children reduce discomfort through simple measures such as keeping hands, feet, and armpits clean and dry, and choosing loose-fitting, sweat-absorbent clothing. Children should maintain a healthy diet and lifestyle. In some cases, doctors may also consider conservative treatments such as topical aluminum chloride antiperspirants, iontophoresis, or other therapies depending on the disease severity and the child's age.

When patients reach an appropriate age and desire definitive treatment, they can visit a hospital for examination and specialized consultation. With the support of modern machinery and equipment, doctors can clearly visualize the anatomical structures within the chest, precisely ablate the sympathetic ganglia, minimize damage to surrounding healthy tissue, shorten surgical time, and facilitate rapid recovery.

If children or adults experience excessive sweating accompanied by unusual symptoms such as fatigue, loss of appetite, unexplained weight loss, prolonged fever, palpitations, or hand tremors, they should seek medical attention to determine the underlying cause.

Not all cases of hyperhidrosis are primary, meaning not caused by another medical condition. Some cases indicate endocrine diseases, metabolic disorders, infections, or systemic illnesses. Therefore, accurately identifying the cause is crucial for selecting the appropriate treatment method.

Master, Doctor, Level 1 Specialist Phan Vu Hong Hai

Chest - Vascular Surgery Center

Tam Anh General Hospital TP HCM