The links didn't work so for those interested, here is a copy of one page of the material that was being questioned. That was simply unbelieveable the way this was handled by the vssgbi personnel.

And that still leaves the problem of how inadequate and misleading the information is that these people are giving out.


'The information contained in this patient information sheet is not a substitute for medical advice or treatment, and the Society recommends consultation with your doctor or health care professional'

1. What is hyperhidrosis?
Hyperhidrosis is excessive sweating. All of us sweat and when it is hot or we are embarrassed or anxious we sweat more. This is normal and it is only when the sweating is excessive and causes ruined clothing or extreme social embarrassment that it is called hyperhidrosis. Generalised hyperhidrosis may be the result of systemic disease such as chronic infection or an over active thyroid. Localised sweating confined to the armpits or hands is not usually associated with any generalised disease.

2. Where does sweat come from?
There are thousands of little glands in the skin that produce sweat. Sweat is one of the ways which the body uses to cool itself. The amount of sweat depends on how hot it is and on stimulation of the sweat glands by the nerves that supply them.

3. Do I need treatment?
Excessive sweating is not harmful in itself. Therefore treatment is only required if the sweating is so severe that it is causing embarrassment or difficulties at work.

4. What treatment is available?
You may initially be prescribed a strong antiperspirant called aluminium chloride. This is applied at night and washed off in the morning. Antiperspirants work better in the armpits than on the hands. If medical treatment is unsuccessful in controlling the sweating, then an operation to divide the nerves that supply the sweat glands may be needed (Thoracoscopic Sympathectomy).

5. What is a thoracoscopic sympathectomy?
The nerves that supply the sweat glands in the armpit and palms can be cut to reduce the amount of sweating. These nerves lie deep in the neck, close to the spine and the traditional operation to divide them, using a neck or armpit incision, left a sizeable scar and were often accompanied by complications. The operation was therefore only done in very severe cases. However, thanks to the development of "keyhole" surgery the nerves can now be destroyed through 2 or 3 tiny holes in the chest using special instruments. This procedure is called a thoracoscopic sympathectomy.

6. How is a thoracoscopic sympathectomy carried out?
You will have a general anaesthetic for the operation. When you are asleep, a small hole is made in the upper chest. The lung, on the side being operated upon, is allowed to collapse a little to make some working room. Meanwhile your other lung is capable of doing all the work. A camera on a thin telescope is then put into the chest to find the nerves which are to be divided One or two other small holes are made to put in the instruments that divide the nerves. The lung is then re-expanded and the instruments removed. Sometimes a small drain (plastic tube) is left in the chest for a few hours to make sure all the air is removed from the chest cavity. It is usually possible to do both left and right sides at the same operation if required.

7. How long do I have to be in hospital?
Although it is possible to have this operation as a day case, in most cases you will be kept in overnight after the operation. Occasionally, if the lung takes a bit of time to expand, you may have to stay in a bit longer. Rarely, a small drain (plastic tube) is needed to help the lung expand. This is more likely if you have both sides done at one operation.

8. How successful is thoracoscopic sympathectomy?
This operation usually gives a satisfactory reduction in the sweating in over 90% of patients and in nearly all cases the results are permanent. The operation is usually more successful for sweating of the palms, than the armpits. Sometimes the palms are so dry after the operation that moisturising cream is needed to prevent cracking of the skin. Stopping the palms and armpits sweating may result in extra sweating elsewhere. This "compensatory" sweating commonly occurs on the back below the shoulder blade.

9. Are there any special complications of thoracoscopic sympathectomy?
The only particular complication is a drooping of the eyelid on the side of the operation due to damage of the nerves in the root of the neck. This is rare with thoracoscopic sympathectomy (less than 1 in 50) and usually recovers. Sometimes the ribs where the telescope was inserted into the chest are sore for a few weeks and hurt on breathing in deeply or coughing. This is due to bruising of the ribs and gradually improves.