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<p><strong>Laser Sweat Ablation</strong></p> <p>Laser Sweat Ablation (LSA) has been pioneered in the UK by Dr Mark Whiteley.  LSA is performed on the axilla under local anaesthetic; two small incisions are made, the dermis is separated by the underlying subcutaneous fat and a laser fibre is inserted.  The laser is fired at the sweat glands, which are destroyed and removed by curettage. </p> <p>Although LSA is a successful and potentially permanent surgical treatment option for axillary hyperhidrosis, it has not been subjected to clinical testing and is not widely available in the UK at the present time. </p> <p> </p> <p><strong>Surgery</strong></p> <p>The decision to have surgery to treat hyperhidrosis is a major one that requires very careful consideration, due to the potential for complications and side effects.  Endoscopic (or Video-assisted) Thoracic Sympathectomy (ETS) is the most common form of surgery, which is performed under a general anaesthetic and is used as a treatment for hyperhidrosis for all areas of the body, with the exception of the feet.  During the operation, the surgeon will insert a camera into the chest in order to identify the sympathetic chain, from which the sympathetic nerves that stimulate the sweat glands radiate.  Small areas of the sympathetic chain are destroyed, thereby removing the stimulation to the glands</p> <p>ETS is carried out both in the NHS and at private hospitals.  Side effects include compensatory sweating, where sweating becomes worse in other areas of the body; this occurs in almost every patient, and in 1 in 20 patients is severe; some patients report that they regret having the operation.</p>

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