Prognosis
Palmar and palmoplantar hyperhidrosis
Untreated, these disorders generally worsen at puberty and rarely improve over the patient's life. Thoracoscopic sympathectomy has a high success rate in achieving relief from hyperhidrosis of the palms alone or in combined disease with the soles of the feet. Treated by thoracoscopic sympathectomy, the palmar component of palmoplantar disorder is permanently cured in the majority of cases. The plantar component is initially improved in about 80% of cases, but not as significantly as the palmar component. In addition, this number decreases with time so that ultimately only a minority of plantar cases benefit from the treatment.[43]
Axillary hyperhidrosis
The natural history of this condition is unclear, but it may improve with increasing age. Medical treatment may provide significant, albeit temporary, relief. Local surgical intervention with axillary gland resection may provide long-lasting relief. Thoracoscopic sympathectomy may be useful, but generally these patients have less satisfaction with the procedure than those with palmar hyperhidrosis.[48] This is because of less efficacy and more complaints of compensatory sweating.
Craniofacial hyperhidrosis
The natural history of this condition is unclear, but it may improve with increasing age. Medical treatment may provide temporary relief. Thoracoscopic sympathectomy for this condition appears more useful compared with its effect in the axillary variety. However, patient satisfaction is lower compared with the palmar variety.[1]
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