What is Primary Hyperhidrosis?
Primary Hyperhidrosis leads to abnormally excessive sweating of the face (also blushing), hands (called palmar), under arms (called axilla), feet (called plantar) and other areas of the body. Most patients relate to significant negative impact on their social and business relationships, as well as activities of daily living (turning a door knob, holding a computer mouse, etc.). Insurance companies will generally "cover" this treatment as a benefit of your health plan agreement and we accept most insurances.

What are the Other Options?
Many of our patients have tried other, often temporary alternatives before considering outpatient, surgical treatment:
• Anti-Perspirants
• Topical Agents such as Drysol
• Pharmaceuticals including Anticholinergics (often have side effects of dry mouth, blurred vision and sedation) Beta Blockers, anti-Anxiety and Sedative medications.
• Iontophoresis application of low intensity electrical bath
• Multiple Botox injections (FDA approved only for under arms)
• Liposuction, Curretage or Excision of the sweat glands
• "Alternative" treatments

How can it be Treated Effectively?

Thoracoscopic Sympathectomy
Thoracoscopic Sympathectomy can be achieved by simply “clipping” (or also called "clamping") the appropriate segments of nerve and ganglion near the back, top and inside the chest. These are standard titanium clips used in many operations to control small blood vessels. On most occasions two clips are both placed above T3 and below T4.
For more information on Thoracoscopic Sympathectomy, click here.

Is Botox Effective for Primary Hyperhidrosis?
Although Botox can be injected into the hands and face, it is best directed to excessive axillary (under arm) sweating. Axillary injections do not require sedation or anesthesia, as is often necessary for injections into the sensitive hands. Botox injections in the axillae can last up to 7 months and should be considered before sympathectomy. Our office performs Botox axillary treatments and many insurance plans will cover this treatment.
For more information on Botox Solutions, click here.

Are the Procedures Covered by Insurance?
There are many different health insurance polices with even more differences in coverage for certain procedures. Generally, most insurance plans cover both Sympathetic Clipping and Botox. Some will approve immediately, while others require a submission of records from our evaluation.

Are there Other Costs to Me?
Your insurance plans may require a Co-Pay or Deductible. For example, a Co-Pay is a $25 payment for each doctor's office visit at the time of service. A Deductible, on the other hand, is paying the initial annual medical costs, at the times of service, (for example, $1000) before your insurance takes over the shared costs of health care. You can call your insurer to determine your costs.

We can offer our assistance to help you understand your coverage and costs. Please contact us if you need assistance.

Which Insurers will Cover the procedure??
The following is a list of the "Good Citizens" that have recognized Hyperhidrosis as a life limiting disease and have covered the Sympathectomy procedure. Although benefits and coverage vary with each plan. If you have a choice in enrolling in more than one plan - you will want to verify that an individual plan covers Hyperhidrosis treatment:

• Aetna
• Anthem
• Blue Cross/Blue Shield of other states
• Blue Cross/Blue Shield of Michigan
• Blue Cross/Blue Shield of Florida
• Blue Care Network
• Care Choices
• First Health
• Great Lakes
• HAP (Health Alliance Plan)
• MCare
• Medicaid
• Medical Mutual
• Medicare
• OHIP with authorization
• PPOM
• United Health Care

The following are other insurers that have recently not covered the procedure:
• NGS
• Principal

Information for Ontario OHIP residents