“Are you OK?”

If you suffer from hyperhidrosis or excessive sweating, this question is the last thing you want to hear when a sweat event strikes. But it never fails.

I remember when my friends asked me this after my first sweat event. We were sitting on the bus to youth group camp and a couple cute girls sat by us (I was 13, so this was a nerve-wracking experience).

When we stopped at a gas station and got out, everyone stared at me in absolute awe: I had a band of sweat around my head that dripped down to my shirt. I looked as if I’d just run a marathon. That was the first time I remember feeling anxiety. And it definitely wasn’t the last. Cranial hyperhidrosis had entered my life, but I had no idea what it was at that time. I just knew something was wrong.

My Early Experience With Hyperhidrosis

My sweat attacks came on gradually, usually triggered by stress or social situations. By the end of junior high, I had become extremely self-conscious about my situation and invented go-to excuses like, “I just got done skateboarding,” or “I was kicking the soccer ball around.” I even grew my hair out and doused it in gel so it looked wet rather than sweaty. But by high school and into college, my sweating kicked into high gear.

Going to school at Cal Poly – where temperatures topped 110 degrees – didn’t help much, either. I strategically planned my walks to class based on shade and proximity to bathrooms (in case I needed to change into one of the two or three shirts I always carried around). I even only chose classes that had air conditioning.

By the end of my freshman year, I had made multiple trips to the campus clinic to discuss my condition with different physicians. They eventually diagnosed me with anxiety disorder, attributing my sweat events to panic attacks.

I remember thinking, “How could I have five to 10 panic attacks a day?” As a result, I was prescribed anti-anxiety medications and antidepressants such as Xanax, Prozac and just about every medication you can imagine. Of course, the pills weren’t reducing my sweating. They only messed with my head and made me disoriented. Ultimately, I didn’t have an anxiety disorder; the anxiety was just a reaction to my excessive sweating.

Needless to say, this bizarre head sweating had affected my life on many levels. And it wasn’t until a friend told me about hyperhidrosis a few years later that I understood what was really going on.

Searching for a Solution to Hyperhidrosis

After learning that cranial hyperhidrosis was, in fact, a real condition, I went to a doctor who advertised a cure for "sweaty palms." That’s when he told me about endoscopic thoracic sympathectomy (ETS) surgery.

To complete the surgery, the doctor would go into my chest cavity and slice the nerve lines around my rib cage that control the fight-or-flight nervous system. For hyperhidrosis sufferers, those nerves tend to be enlarged and trigger sweat when it’s unnecessary. Or he could go with the nonpermanent procedure and clamp off two to three nerves, but he didn’t talk much more about that.

He went on to explain the potential side effects — the potential for infection, my lung collapsing or Horner’s syndrome (constricted pupil and/or droopy eyelid). But I was desperate for a solution. So I went for it and opted for the permanent solution. A decision I regret to this day.

Undergoing ETS Surgery for Hyperhidrosis: The Aftermath

I was dry for one week post-surgery. After that, what I thought was ghost sweat (the feeling of sweating) turned out to be the real thing. I began sweating on my chest, much worse than I had on my head before the surgery! The weirdest thing is I now have a very defined area on my torso, front and back, where I sweat. I'm dry as a desert above a line on my lower chest and swampy wet down to my belly button.

So naturally, I went back to the doctor, and that’ the first time he told me about the high likelihood of compensatory sweating, meaning other areas of my body sweat profusely in response to the surgery.

As each day passed, it only got worse. By the end of summer, I had to wear two to three undershirts to contain the bulk of the sweat. Then, out of nowhere, the sweating appeared on my left shoulder blade. Of course, my doctor kept blaming it on the heat. But by then, I was going through four to five undershirts a day.

So here I am, stuck with torso sweating that is much worse than the sweat from my head and a random area on my left shoulder blade. Try explaining that to people.

The side effects of ETS didn’t end with sweating, either. I experienced a noticeable lack of energy and felt like my thought process was flawed. It took three times longer to make a simple impulse purchase decision than it used to. My natural feelings of assertiveness seemed to diminish because ETS impairs your fight-or-flight capabilities.

The surgery also made my face super dry or oily, and acne appeared for the first time ever. Eventually, the effects trickled down to my hands, which also dried up badly. My metabolism was cut in half. My scalp dried out. Then I started to dramatically lose my hair. Search YouTube for “ETS Side Effects,” and you’ll get some real-life experiences. Be cautious of clicking on the ads, which are most likely pro-ETS.

The doctor clearly wasn’t telling me the whole picture. After reaching out to other patients, they were all furious with this doctor and the results of the procedure as well.

Alternatives to ETS Surgery for Excessive Sweating

Opting for the surgery was the biggest mistake of my life — an experience I wouldn’t wish upon anyone. But when you’re young, desperate and confused about what excessive sweating actually is, you just don’t question a doctor.

But not all hope is lost. You can adjust. For me, by keeping fans on and air circulating, my hyperhidrosis tends to stay dormant. I also stay proactive by drinking plenty of water and minimizing my stimulant intake (sugar, caffeine, etc.) Although hot weather still cranks my sweating into high gear, my anxiety (and anxious sweating) is no longer an issue thanks to some tricks I’ve picked up.

Obviously, I would never recommend ETS surgery for hyperhidrosis. And before blindly following a doctor’s suggestion or opting for a procedure like I did, here are some steps you should take first:

  • Do your research, and consider all alternatives. You don’t know how severe your hyperhidrosis is until you embrace it. Only once you fully wrap your head around it can you learn to manage it.When you’re uneducated about the problem or don’t even know what it means, it’s easy to jump to rash conclusions. The International Hyperhidrosis Society offers unbiased, comprehensive information on the procedure here. I wish I had this info back when I was considering this option. Always do extensive research before resorting to an invasive procedure like ETS. And remember: There are alternatives.
  • Ask doctors how many ETS procedures they’ve successfully done, and get multiple referrals. Just because one doctor is able to perform ETS surgery doesn’t mean he’s an expert on hyperhidrosis or knows how to effectively treat it. Visit a handful of doctors, and compare their recommendations. Ask to speak to their patients, particularly those who had the surgery at least two years prior. Some complications from this procedure do not become apparent for five to 10 years after.
  • Start with a dermatologist. Dermatologists seem to be ones who understand hyperhidrosis the best and won’t jump to conclusions about anxiety disorders first. They realize it’s not a psychological condition. Start your search here rather than a general practitioner.
  • Join online support groups. I haven’t told many people about my cranial hyperhidrosis because I know they couldn’t begin to understand it. Having a group of people who get what you’re going through and can offer support and advice is very therapeutic. I recommend checking out My Life as a Puddle, the ETS and Reversals Discussion Forum or SweatHelp.org.
  • Be proactive. Make a plan to keep rags, extra shirts, water or whatever you need on hand in case a sweat attack strikes. Just having a “sweat kit” handy prepares you to handle these situations and creates a sense of relief that can keep you calm during sweat attacks, too.

Thompson Tee: A Safe & Affordable Solution to Hyperhidrosis

Dealing with my cranial hyperhidrosis has been a lifelong struggle. The psychological toll of excessive sweating is impossible to understand from the outside.

So when my co-founder Billy came to me with the idea for the Thompson Tee, I was immediately all-in. Even though the product isn’t designed for my particular problem, I wanted to help anyone with excessive sweating in any way I could. Also knowing that ETS was recommended for excessive underarm sweat (axillary hyperhidrosis), I had to take this opportunity to help others avoid what I consider the biggest mistake of my life.

We regularly get testimonials from customers who were one step away from this surgery but no longer needed it thanks to the Thompson Tee.

Seeing the Thompson Tee transform the lives of people around the world with axillary hyperhidrosis or excessive sweating who can relate to my experiences has been beyond fulfilling. That’s what pushes us to keep going every day.*

With Billy dealing with axillary hyperhidrosis himself, we created the perfect team to truly understand our customers. Our passion is to offer a safe, affordable and convenient solution to those dealing with excessive sweat. Now, people in every U.S. state and over 80 countries rely on our sweat proof undershirts every day. We encourage you to try a Thompson Tee risk-free before opting for expensive & invasive solutions to hyperhidrosis like ETS surgery.

What other questions do you have about ETS surgery for hyperhidrosis? Or what alternatives to ETS surgery would you recommend? We'd love to hear your stories & suggestions in the comments. 

*Sidenote: I have over 20 years in the domestic apparel business. Billy was not aware I had suffered from cranial hyperhidrosis when he approached me with the idea for Thompson Tee.

By Randy Choi, co-founder of Thompson Tee