Can I Use Iontophoresis If I've Had ETS?

ETS: Endoscopic Thoracic Sympathectomy

Endoscopic Thoracic Sympathectomy (ETS) is a highly risky procedure that is only reserved for the most severe cases of palmar hyperhidrosis, also known as excessive sweating of the hands. It is a controversial and highly risky procedure associated with serious side-effects, and is even banned in certain countries due to its associated risks.

Can I use iontophoresis even if I’ve had ETS?

You can use iontophoresis to treat hyperhidrosis, even if you’ve undergone ETS.

While ETS may eliminate excessive hand sweating, it almost always leads to compensatory sweating in other areas of the body. If you now suffer from excessive sweating in other areas of the body, such as your feet and/or underarms, you can use iontophoresis to treat these areas. If the ETS procedure was not successful and you are still sweating from your hands, you equally may use iontophoresis to treat palmar hyperhidrosis (excessive hand sweating). Dermadry’s iontophoresis device treats excessive sweating of the hands, feet, and underarms.

If you’ve undergone ETS and now suffer from full-body compensatory sweating, or are sweating from areas where iontophoresis treatment cannot be used, we suggest you speak to your primary care physician or dermatologist to work out the next steps and seek out alternative treatment options.

To learn more about iontophoresis and if it’s the right treatment for you (including contraindications), check out our iontophoresis page.

What is Endoscopic Thoracic Sympathectomy (ETS)?

ETS is a surgery performed to treat palmar hyperhidrosis, also known as excessive hand sweating. During ETS surgery, a surgeon will attempt to interrupt the transmission of nerve signals from the spinal column to the sweat glands to stop the sweating. The patient is under general anesthesia when the procedure is done, as the surgeon must temporarily collapse a lung in order to destroy the nerve paths associated with the overactive sweat glands. It is generally done to treat severe cases of palmar hyperhidrosis, when no other treatment options have worked.

This is a permanent procedure, no successful reversals have ever been done. The procedure is highly risky and generally results in compensatory sweating all over the body, which is often even more excessive than the sweating the patient was experiencing before. While some patients may experience dryness in their hands, they will be sweating excessively everywhere else on their body, which can be even more life-altering than palmar hyperhidrosis.

Is Endoscopic Thoracic Sympathectomy (ETS) safe?

No, ETS is overall not a safe surgery as the side-effects outweigh the potential benefits of the surgery. Some of the most serious side-effects include compensatory sweating, gustatory sweating, Horner’s syndrome, neuritis and neuralgia, brachial plexus Injury, extreme hypotension, heat intolerance, and arrhythmia. Additionally, the risks associated with surgery and undergoing anesthesia must also be considered.

The International Hyperhidrosis Society advises against this surgery, and notes on their website that there are often irreversible side effects caused by endoscopic thoracic sympathectomy (ETS) surgery, and it has even led to death in some cases.

You can read the stories of many who have undergone this procedure and regret it in forums dedicated to raising awareness of the dangers of this surgery. For first-hand experiences, consult ETS Awareness, a project dedicated to raising awareness of the dangers and side-effects of ETS surgery.

Why choose iontophoresis? (Iontophoresis vs ETS)

Iontophoresis is a non-invasive (doesn’t penetrate the skin), drug-free, needle-free, and surgical-free way to treat excessive sweating. Unlike ETS surgery, iontophoresis is not permanent and is not associated with any serious side effects. Iontophoresis treatment adapts to your schedule and lifestyle and can be done in the comfort of your home using a portable device such as Dermadry. Learn more about Dermadry’s FDA cleared iontophoresis machine and iontophoresis technology here!