SDLA for compensatory sweating

JCS

Member
My original problem was both facial and armpit sweating that developed during ****rty, leaving me painfully shy and subject to severe panic attacks that started in highschool and continued through college. Finally found a doctor that supplied some anticholinergic and antianxiety medications that allowed me to finish highschool, and continue through graduate school. Found that wearing a baseball cap was a great way to deal with or hide the facial/scalp sweating, but it only exacerbated my premature hair loss. Discovered the soothing effects of alcohol in college and drank to excess up until about four years ago. I’m almost 50 now. In hindsight, I should have embraced my hair loss, shaved my head, and continued to use the medications although they were only moderately effective.
After the failure of a two-year relationship about 15 years ago, largely due to my social anxiety, drinking, emotional unavailability and total lack of spontaneity, I learned about the sympathectomy procedure. The surgery went fine with no immediate complications, effectively eliminating all sweating from the head and underarms. However, by the time I had returned home, I began to experience debilitating compensatory sweating over the trunk of my body, especially my chest and back. Ever since, I have had to take even higher doses of anticholinergics, along with clothing camouflage and the avoidance of social triggers, just to be able to marginally function.
Two days ago I had the Subdural Laser Ablation (SDLA) treatment on my chest and back in a last ditch effort to achieve some relief and enjoy the rest of my life. Going off the medications in preparation for the surgery reminded me just how bad the CS is without some treatment. The day of the procedure, my back and shirt were soaked (you could literally wring sweat out of each) just from a short walk to the clinic in <70 F weather.
In an effort to help others with similar afflictions, I thought I would make periodic updates about my status and the effectiveness of the SDLA procedure. Also find below two pictures of the treated areas taken a day after the SDLA procedure.
Hopefully some of you will find this information helpful.
 

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JCS

Member
The procedure was only minimally painful as you are given a subdural anesthetic in the area to be treated. After treatment, you are instructed to apply an antibiotic cream to the area and then cover with saran wrap to ensure it stays moist for the first three days. This can be quite difficult for the back area and keeping the saran in place is challenging. The biggest shock came the next day when I woke up and found a significant amount of blood and fluid from the area. Difficult to tell if there was much blood or just a combination of the cream and other oozing skin fluids, possibly including sweat from untreated areas that are covered by the saran.
For me the pain has been minimal so far. More like a sunburn combined with a soreness that is similar to muscle soreness from exercise. Still seems to be some oozing, so it is unclear how effective the treatment is for CS after just two days of taking it easy. Will post updates on a regular basis.
 

NickM

Well-known member
Thanks for posting about this. A thread like this might be very useful for someone considering SDLA. Did Dr. Nielson perform your procedure?


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JCS

Member
Post treatment day three (Guardedly optimistic): skin looks about the same and feels numb and rough to the touch. Initially worried about possible hair loss on the chest, but shaved hairs appear to be growing back quite fast. May start to itch in a few days. Despite the redness, doesn’t appear to be any blistering and the oozing has lessened. I am guardedly optimistic as the treated areas do appear to be staying dry. Somewhat hard to tell while still regularly applying the antibiotic cream and the saran wrap traps sweat from adjacent untreated areas. Today is the last recommended day to use the cream, but may continue since my skin remains so red. Will take another set of pictures in a day or so.
JCS
 

JCS

Member
This thread is mainly to discuss my experiences with SDLA, but I welcome other questions regarding HH and CS. It is good to know someone else is out there. I have never taken much comfort from such forums in the past. Camouflage, conceal, move forward has been my entire coping strategy. Never having an honest conversation about this issue with anyone outside the healthcare profession.
 

CharlesN

Well-known member
Sounds pretty involved, good luck and I'm sure if it works, the temporary pain will be well worth the long term relief!
 

johnk

Active member
Thank you so much for your post!I am 23 years old and i suffer mainly from armpit and when i am too anxious from back and chest hyperhidrosis.I am so desperate that i m sitting on computer many hours in order to find a good solution.For armpits i have botox with very good results but it must me done each 6 months.For back and chest i have only found that odaban antiperspirant may works!i haven t apply it yet but i m going to.Please keep inform us for your procedure,it sounds so promising:):)
 

JCS

Member
Day four. Somewhat despondent. Seems like the treated areas are still sweating, but not sure because of need to keep the areas covered in antibiotic cream and wrapped in saran. The Dr. did say it could be a week for the treatment to take full effect. Some areas on my chest look like they will soon start to peal. The biggest problem has been not being able to exercise, i.e., run or lift weights. Even though the Dr.’s recommendations only said two days rest before exercise, my back and chest feel like such activities would make things worse. Still, that will be the test. Am I the one that looks like I’ve run a marathon before even warming up. Even so, planning to go for a short run this evening.
One other fact for the less informed. SDLA can be quite expensive, especially if you have large areas that need treatment. My only goal is to give the whole truth.
 

JCS

Member
Day five, outlook improved. Skin still looks like hell (pics soon to come). Finally had a chance to do a 2 mile run on the treadmill last night and afterward I removed my shirt to find a four inch dry streak down the back of my t shirt where I had the SDLA. Same for my chest as well. Hadn’t taken any Ditropan or Levsin, so the SDLA seems to be effective. I think I mistook the tenderness of my skin, some initial oozing from the treated areas, and my shirt sticking to the tender skin as a sign of sweating. Also, adjacent areas still sweat. I don’t think a wide enough area of the back was treated, but that can wait till my skin and bank account have recovered. Still have CS in other areas, but this is a solid improvement.
Will continue to post updates in the coming days.
 

johnk

Active member
One question.Is SDLA possible to create by itself compensatory sweating;;I m wondering for example if it is a feasible solution for people that didn't have EST surgery and sweat at back and chest.Thank you so much for your updates.So helpful
 

JCS

Member
johnK,
SDLA doesn't cause CS. You do seem to notice the sweating in non SDLA treated areas a bit more, but nothing like the immediate, severe Cs that can follow ETS I recommend it for chest and back instead of ETS. SDLA is so new you need to check around as doctors may have their own techniques that vary more than standard ETS.
Hope this is helpful
 

JCS

Member
SDLA continues to be effective, but will likely need to have a larger area of the lower back treated in the future. The sensitivity of my skin and the tendency for my shirt to stick makes me think I am wetter than is the case. Was traveling in the car for two hours today, and my shirt wasn’t soaked as in the past. Yesterday I tried to take a picture after running illustrating the new sweat pattern but it didn’t show up prominently enough in the photo.
 

NickM

Well-known member
We really appreciate the consistent updates. Please keep it up!


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JCS

Member
Day seven, with pictures attached. Will consume the last of my antibiotics today. Never needed the prescribed painkillers. Chest seems to be healing faster than back. Much of the skin has pealed off leaving new pink skin underneath while back is still much redder. Still applying cream as often as feasible. Was finally able to go to the gym and weightlift/exercise since the procedure, aside from short runs on the treadmill. Makes everything much better. Hard to believe but I lost 5-10 pounds since the procedure, just haven’t had the appetite.

Although it’s early, I have to conclude that SDLA was effective. As noted earlier, will still need follow-up treatment in other adjacent areas. After the horrible side effects of ETS I was quite skeptical.

Will continue to post updates, but a key issue has become apparent “What now?” What happens when you resolve/improve a major debilitating issue in your life? You’re still the same person, with all the other flaws and experiences.
 

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JCS

Member
Day Eleven. Yesterday I had the first phone consult with doctor since procedure. Discussed concerns over continued skin redness, especially on my back. Also the scar on my chest is quite large. The incision clip came loose soon after the procedure, and failed to keep the skin tightly together. Was told to continue using the lotion as often as possible. Chest area appears to be healing much faster, but it will be a long time before I can change shirts at the gym.

Both areas are beginning to itch considerably, which I assume is a sign of healing. Yesterday was one of the first very warm, humid days of the year, and I was surprised by how bad the HH was despite the SDLA. Areas adjacent to the treated zones still sweat profusely, especially on the lower back where much of the area was left untreated. Will need to have this area treated. This was also a reminder that I will still need to take the medications despite SDLA to be able to function in this hot, humid climate.

So while this is not a panacea, I still recommend SDLA over ETS.

More as things progress.
 

JCS

Member
Two weeks. As of today it has been two weeks since SDLA. As noted in previous posts, the treatment seems quite effective for back and chest. Unfortunately, some adjacent areas still sweat quite profusely, necessitating additional treatment in the future. Two obvious drawbacks, the procedure is quite expensive for treating large areas (i.e., will be paying for this a long time) and the skin on my back doesn’t seem to be recovering as fast as initially expected. Chest area appears to be healing much faster. Doesn’t hurt and isn’t pealing, but still very red. Applying lotion to the area as often as possible.
 

etsveteran

Well-known member
First off, congratulations on your perseverance. I had ETS in 1998 and have had hair loss for around 15 years that has stabilized with Finasteride and Rogaine. My feet sweating is still very bothersome and has probably increased since I had ETS. So I fully empathize with you.

However, before people start going to Nielsen for this procedure, I think it is prudent to read some of the mishaps and sad stories several people have posted on my site's forums:

Laser Treatment for Sweating

I do not mean to discourage you and hope you are an exception and Nielsen's technique has improved. I am very glad you did not get the feet or groin areas done, as those seem to result in the worst side effects.

I will be following this thread for sure.
 

BCNGuy

New member
First of all, thanks... and good luck!!

I am looking for a doctor in Barcelona who knows this technique.

Can you update your status?? Thanks again
 
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