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Some people suffer with severe facial blushing and
sweating. The symptoms may affect just the face or include the head, neck and
upper chest. Excessive facial blushing often results in extreme social
embarrassment for patients. If this is associated with excessive sweating as
well, their face, head, hair and neck may be dripping with sweat. Blushing can
vary from redness of the face to red blotches appearing over the face, neck and
upper chest. Sometimes these symptoms are accompanied by a sensation of having a
hot flush. All of these symptoms are usually precipitated by social interaction
which results in loss of confidence, damage to personal relationships and
compromise to employment prospects.
Relatively recently, it has been recognised that patients suffering from facial
blushing and sweating may respond to Endoscopic Thoracic
Sympathectomy (ETS), an operation which has been performed routinely for
treatment of palmar hyperhidrosis. The results are certainly not as good as they
are for hand sweating, but about 70% patients with severe facial blushing have a
favourable response to ETS. In addition to all the potential side-effects of ETS,
patients in whom this operation is used to treat facial blushing must be aware
of the potential failure rate. Also, the operation may be more successful on one
side of the face than the other which can give rise to a "Harlequin effect".
However, facial blushing and sweating cannot easily be treated by other means
and for many patients with this condition in whom life is unbearable, ETS may be
the only option despite the results of the operation being less than perfect in
some patients.
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