Plantar (feet) Hyperhidrosis

Plantar hyperhidrosis is another term for excessively sweaty feet. Plantar Hyperhidrosis often occurs in conjunction with excessive hand sweating or sweaty palms. Even though excessively sweaty feet are not as functionally or socially unacceptable or obvious as sweaty palms, the disorder still poses its own set of uncomfortable issues. People with excessively sweaty feet find that shoes can be ruined, trying on shoes in public is embarrassing, wearing high heels is difficult, sandals cannot be worn comfortably, and foot odor and fungal infection can cause discomfort and embarrassment. Those suffering from excessive foot sweating should only use socks made from a natural fiber, typically cotton which allows the skin to breathe. Additionally, feet should be left open to the air as often as possible. Synthetic shoes and man-made fibers tend to exacerbate this problem and should be avoided.

Symptoms of plantar hyperhidrosis

  • Sweat dripping from feet without excessive activity
  • Having to change socks frequently during the day
  • Excessive foot odor
  • Inability to wear sandals or high heel shoes because of wet feet
  • Hesitant to try on shoes in public
  • Excessive fungal infections

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Treatment Options for Plantar hyperhidrosis:

  1. Topical agents (Drysol, Odaban)
  2. Treatment with topical agents should be tried as a first line defense against plantar hyperhidrosis. The product should be applied only at bedtime after bathing, when relaxed, to DRY skin. The following morning the treated areas should be washed to remove any excess possibly left on the skin. Topical agents are usually ineffective against most forms of excessive facial sweating, but should be attempted.

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  3. Iontophoresis
  4. Your physician may consider using iontophoresis which works by passing a low dose electrical current through wet skin in order to coagulate protein in the sweat ducts to form temporary plugs. The partial blocking of the sweat glands subsequently reduces the rate of perspiration. The treatment involves immersing the effected part of the body into water or having damp pads attached through which an electrical current is passed for around twenty to thirty minutes.

    The process causes a strong tickling sensation that varies according to the strength of the current used. Iontophoresis is a safe and useful complimentary treatment to an antiperspirant, especially for palmar (sweaty hands) and plantar (sweaty feet) hyperhidrosis; however, some individuals find the necessary regime too inconvenient.

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  5. BOTOX® –  Botolinum Toxin
  6. As a last resort for plantar hyperhidrosis, botolinum toxin treatments can be considered. BOTOX® is a brand name for a bacterial toxin that is used medically to paralyze the nervous activity of the sweat ducts which prevents the production of perspiration. It was first approved for use on humans by the United States by the FDA in December 1989, and approved as a treatment for underarm sweating in 2004.

    Although BOTOX injections are commonly used and highly effective in the  treatment of  sweaty armpits, the treatment requires multiple treatments a year. For plantar (sweaty feet) hyperhidrosis, treatment is very painful.

    On average, each foot requires more than 50 BOTOX injections. All these numbers can vary depending upon the size of an individual’s hands, feet and armpits; the amount of sweating in each area (i.e., the intensity and area of hyperhidrosis); and the practitioner’s preference and experience in treating hyperhidrosis with BOTOX injections.BOTOX can be quite expensive because of its limited duration of effect.

  7. Endoscopic Lumbar Sympathectomy

       This sympathectomy is done in the abdominal region for plantar hyperhidrosis. Similar to Endoscopic Thoracic Sympathectomy (ETS), it is a minimally invasive procedure through three to four tiny 5 mm incisions in the flank. The lower lumbar sympathectic chain are cut and removed. Patients usually stay overnight in the hospital and return to normal activity within a week.

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Frequently Asked Questions 

Does insurace cover this procedure?
The majority of health insurance carriers cover the procedure. In the case of patients with no health care coverage, special affordable rates and monthly plans are also available. Our staff can assist you with health care coverage and contacting your insurance company and also with providing possible monthly payment plan.

How soon can I have ETS done?
The operation is offered only after consultation with your surgeon. He will explain the procedure to you in detail and answer your questions. After the procedure has been thoroughly explained to you, the surgery can be scheduled at your convenience.

How long will I be off school or work?
Most people can go back to work or school after 3 days.

When can I expect results?
The results are immediate.

May I talk to patients who have had the procedure?
Yes, in fact we encourage you to speak with our previous patients. This would give you a better perspective about what to expect. We will provide contact information of patients who have agreed to be contacted about their procedure.

Is there any scarring?
We do this operation with one or two very small incisions (less than 5 mm) that leave cosmetically small scars that are well hidden in the armpit.

How long will I be in the hospital?
This is an outpatient procedure. The surgery is done in the morning and most patients go home the same day by lunch.



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