ETS surgery for excessive sweating: a last resort

At a glance

How it works

The surgeon cuts, burns, or clamps nerves in the chest that carry signals to sweat glands in the upper body.

Why it comes last

Strong antiperspirants, iontophoresis, Botox, and pills are less invasive. ETS is usually discussed only for severe hand sweating that has not improved with those options. It is rarely used for underarm sweating.

Sweating elsewhere is the main risk

Sweating can increase on the chest, back, stomach, or legs after surgery. It can be permanent and may feel worse than the original hand sweating. The chance and severity vary by person and surgical method.

Effect on hand sweating

Hands often become dry within hours. They can become too dry. Satisfaction may fall over time if sweating starts or worsens elsewhere.

Face and scalp sweating

Surgery for face and scalp sweating carries added risks, including a drooping eyelid and a smaller pupil on one side. Many surgeons prefer other treatments.

When to discuss it

A discussion may make sense when hand sweating is severe, other treatments failed, and you understand the lasting risks. Speak with a chest surgeon who has specific experience treating excessive sweating.

What to consider

• • Type: surgery under general anesthesia
• • Schedule: one operation, treated as irreversible
• • Cost: high, with varied insurance coverage
• • Use: experienced chest surgeon required
• • Body area: mainly hands; face and scalp only with great care

Side effects and reasons this may not be safe for you

• • Compensatory sweating (potentially permanent, can be severe)
• • Drooping eyelid or smaller pupil on one side
• • Collapsed lung
• • Slower heart rate, including during exercise
• • Surgical infection or bleeding
• • The operation may not be reversible

Sources for this treatment

Important numbers and approved uses on this page link back to the research or official information that supports them.

Frequently asked

Should I get ETS for hand sweating?

Usually only after strong antiperspirants, iontophoresis, Botox, and pills have failed. Sweating elsewhere can be severe and permanent. An experienced chest surgeon should explain the risks.

Is ETS reversible?

Cutting nerves is irreversible. Removing a clamp may not restore normal nerve function. Treat the choice as permanent.

Why is ETS a last resort?

The operation is invasive and can cause permanent sweating elsewhere. Safer treatments work for many people.

Read next

• Check my sweating →
• Where sweating happens →
• How we research our guides →

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