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Surgery for excessive sweating and blushing
Surgery for excessive sweating and blushing, i.e. sympathetic nerve blockade, is an effective treatment for severe excessive sweating of the hands and facial blushing when other treatments are not sufficient. The need is always assessed individually.
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Specialist in the article
Gastroent. kirurgian erikoislääkäri, professori
Revised 12/15/2025
Surgery for excessive sweating and blushing in brief
- Sympathetic nerve blockade, i.e. endoscopic thoracic sympathetic block (ESB), is an effective treatment for severe excessive sweating of the hands and facial blushing.
- The procedure is performed endoscopically, and its effect often begins immediately.
- Recovery is fast, and you can usually go home already on the day of surgery.
When to have surgery for excessive sweating and blushing?
The sympathetic nervous system regulates sweating, heart rate and the function of the skin’s blood vessels. When overreaction of the nervous system causes excessive sweating of the hands or facial blushing, endoscopic blockade can calm the activity. Sympathetic nerve blockade is most effective for severe excessive sweating of the hands, i.e. hyperhidrosis, and selectively for facial blushing when other treatments are not sufficient. The effect often begins immediately after the surgery.
Benefits of surgery for excessive sweating and blushing:
- Sweating of the hands decreases significantly or stops permanently for many.
- Facial blushing and the associated heightened emotional arousal ease.
- The endoscopic procedure performed through small incisions usually allows discharge home on the same day.
- A quickly noticeable effect and return to everyday life within a few days.
Preparing for surgery for excessive sweating and blushing
Surgery for excessive sweating and blushing requires careful, individual pre-examination and a procedural plan. Before the surgery, the physician reviews your situation and discusses your symptoms and possible triggers with you, such as stress and underlying diseases.
Our surgery coordinator will call about a week before the surgery to ensure that your preparations have proceeded as agreed. They will also inform you about matters to note on the day of surgery, such as eating, drinking and arriving at the hospital.
At least consider the following when preparing for surgery for excessive sweating and blushing:
- Nutrition. Do not eat or drink anything for six hours before the surgery.
- Smoking. Stop using nicotine products at least two weeks before the surgery — preferably completely.
- Arrangements related to discharge. The surgery does not require an overnight stay in the hospital, provided that you have someone with you at home for the first night.
- Recovery. Prepare for sick leave and make sure you can get help with household chores and shopping during your recovery.
How surgery for excessive sweating and blushing proceeds
On the morning of the surgery day, you will meet the operating surgeon and the anaesthesiologist. They will go through matters related to the course of the surgery and pain management. The surgery is usually performed under general anaesthesia.
During the surgery, you will be cared for by the surgeon, the anaesthesiologist and the operating room nurses. The surgery is performed endoscopically, typically with two small incisions. The surgeon identifies the sympathetic nerve chain in the chest and blocks it. The procedure typically lasts 30–60 minutes.
After the surgery, your condition will be monitored in the recovery room under the supervision of a nurse. Once you have woken up, you will receive something to eat and drink.
You can usually go home about 4 hours later. Before discharge, you will meet the surgeon, who will explain how the surgery went. You will receive clear instructions on pain management and other aspects of recovery. In addition, you will be given appointments for any necessary follow-up visits.
Recovery from surgery for excessive sweating and blushing
Recovery from surgery for excessive sweating and blushing usually occurs quickly, and return to light everyday activities is possible already 2–5 days after the surgery. The effect of the surgery on sweating and blushing usually begins immediately.
- Exercise. Light physical activity can be increased according to how you feel.
- Sports. It is advisable to avoid strenuous exertion and sports for about 2 weeks after the surgery.
- Return to work. You can often return to light work after 3 days and to heavy work about a week after the surgery.
- Removal of sutures. Self-absorbing sutures typically disappear within two weeks.
Prices for appointments with specialists, such as gynaecologists, dermatologists, cardiologists, orthopaedists and ophthalmologists, can be found in our appointment booking service.
Take into account in the price list
The price estimate includes the Kanta fee and the outpatient fee.| Service | Price estimate |
|---|---|
| Appointment with a specialist, 20 min Price per appointment. | from 99,80 € Without Kela reimbursement from 129,80 € |
| Appointment with a specialist, 30 min Price per appointment. | from 114,80 € Without Kela reimbursement from 144,80 € |
| Appointment with a specialist, 45 min Price per appointment. | from 142,80 € Without Kela reimbursement from 172,80 € |
| Gynaecologist's appointment, 20 min | from 69,80 € Without Kela reimbursement from 139,80 € |
| Gynaecologist's appointment, 30 min | from 74,80 € Without Kela reimbursement from 144,80 € |
| Dermatologist's appointment, 20 min | from 117,70 € Without Kela reimbursement from 147,70 € |
| Dermatologist's appointment, 30 min | from 127,80 € Without Kela reimbursement from 157,80 € |
| ENT doctor's appointment, 20 min | from 112,80 € Without Kela reimbursement from 142,80 € |
| ENT doctor's appointment, 30 min | from 133,80 € Without Kela reimbursement from 163,80 € |
| Paediatrician's appointment, 20 min | from 115,20 € Without Kela reimbursement from 145,20 € |
| Paediatrician's appointment, 30 min | from 134,80 € Without Kela reimbursement from 164,80 € |
| Orthopaedist's appointment, 20 min | from 111,80 € Without Kela reimbursement from 141,80 € |
| Orthopaedist's appointment, 30 min | from 133,80 € Without Kela reimbursement from 163,80 € |
| Appointment with a psychiatrist, 45 min Price per appointment. | from 109,80 € Without Kela reimbursement from 159,80 € |
| Appointment with a psychiatrist, 60 min Price per appointment. | from 120,80 € Without Kela reimbursement from 180,80 € |
| Ophthalmologist's appointment, 30 min | from 127,80 € Without Kela reimbursement from 157,80 € |
| Ophthalmologist's appointment, 45 min | from 138,80 € Without Kela reimbursement from 168,80 € |
Frequently asked questions about surgery for excessive sweating and blushing
Sympathetic nerve blockade, i.e. endoscopic thoracic sympathetic block (ESB), is an endoscopic surgery in which the sympathetic nerve chain in the chest is blocked to reduce excessive sweating or blushing. The surgery is performed under general anaesthesia through small incisions, and discharge often takes place on the same day.
Sympathetic nerve blockade is primarily suitable for severe sweating of the hands, i.e. palmar hyperhidrosis, and socially impairing facial blushing when other treatment is not sufficient. Suitability for surgery is assessed at a specialist’s practice, where treatment history, health status and risks are reviewed.
The response for underarm sweating is more variable than for hand sweating. In severe underarm sweating, botulinum toxin and topical treatments are often the first-line treatment options. Before the surgery, the surgeon’s individual assessment is important.
The most common adverse effect is compensatory sweating on the trunk. Possible side effects can also include dryness of the hands or face. Risks are always discussed at the practice before the actual surgery decision.
Sympathetic nerve blockade performed with clips can in some situations be reversed by removing the clips. Alleviation of adverse effects is more likely if the removal is done soon after the original procedure. The decision is made with the surgeon based on an assessment of the situation.
Resting heart rate and blood pressure may decrease somewhat, and in the initial phase achieving maximal performance may feel more demanding. For most, everyday life becomes easier when sweating or blushing calms down. Instructions for continuing physical activity and work are given individually
