Endoscopic Thoracic Sympathectomy for Facial Blushing and Craniofacial Hyperhidrosis

There is growing interest on the internet regarding treatment options for facial blushing and craniofacial hyperhidrosis. If patients seek medical help they should be advised to see a dermatologist or an internist to rule out serious underlying disorders before surgical options are discussed. Patients with emotionally triggered blushing should also be encouraged to try non-surgical options as the first line of treatment. Provided they fail this and there is still an indication for treatment, facial blushing may be treated effectively by sympathetic surgery. The key to success in sympathetic surgery for facial blushing lies in meticulous and critical patient selection, ensuring that patients are thoroughly informed about the high risk of adverse effects. With proper patient selection the majority of patients treated surgically are very satisfied with the result of the operation but approximately 10% regret the operation because of adverse effects. More quality research that compares surgical, non-surgical, and psychotherapeutic treatments is urgently needed.