Mandie Harris, 20, a college art student from Johnstown, couldn't work successfully with charcoal or watercolors because the heavy sweat off her hands would smudge her art. The same problem had made her reluctant to hold hands with her high school boyfriend.

Contractor Don Shoemaker, 35, can commiserate with Ms. Harris. He was so reluctant to greet guests with an overly sweaty handshake that he didn't want to have a wedding. Somehow he got through it.

They suffered from hyperhidrosis, which brings with it excessive sweating, usually from the palms, feet, armpits and/or the head and face.

Before having surgery to treat their conditions, both tried all sorts of palliatives and cures to no avail. They visited doctors, both family physicians and dermatologists. Each tried a product called Drysol, and Ms. Harris used special antiperspirants that made her break out in rashes. Mr. Shoemaker, of Smithton, Westmoreland County, used skin-drying lime from concrete and he bought an electric machine that shocked the hands. In what he considered a last-ditch attempt to dry out his palms, he tried Botox.

"That was really painful. That's all I can tell you," he said, adding that the doctor put anywhere from 25 to 35 needles in one hand. "It slowed [the sweating] down maybe by 25 percent." He passed on having his other hand done.

But the sweaty palm problems went away for both Ms. Harris and Mr. Shoemaker after they underwent a fairly simple surgery called endoscopic thoracic sympathectomy. It involves cutting a little branch of the sympathetic nerve that controls the sweat glands. Which branch is cut depends upon which body part the patient wants to stay dry.

Ms. Harris and Mr. Shoemaker both were operated on by thoracic surgeon Dr. Manisha Shende. An assistant professor of surgery in the Heart, Lung & Esophageal Institute of UPMC, Dr. Shende estimated she handles 90 percent of such surgeries in the area.

Dr. Shende said during the 3 1/2 years she's been at UPMC she's done the nerve surgery on people from as far away as Erie. She's also done a lot of them. "In the last year and a half, I've done about 70," she said. "This is without advertising. People talk."

No wonder. The surgeon said between 2 1/2 percent and 3 percent of the population has the condition.

Dr. Shende, 44 and a native of Mumbai, India, learned the procedure while she was training as a thoracic surgeon at the Mayo Clinic in Minnesota. She then moved for three years to New Jersey, where she began developing her reputation for the procedure.

"I love doing these," she said of the procedures, which comprise less than one-fourth of her surgical practice. "They are the most grateful patients I have. It changes their lives."

The patient is put under general anesthesia with his or her arms outstretched to afford the surgeon access to the designated branch of the sympathetic nerve and to keep the patient still. The entire procedure takes 15 minutes, Dr. Shende said.

She makes two incisions of 3 millimeters to 5 millimeters under each arm to reach the targeted branch of the nerve.

"They're very well hidden," she added. "There are no stitches, no dressings. They go home that day. They can go back to work in a day or two; students can return to school the next day."

Dr. Shende said 99 percent of the hand patients are satisfied with the results and satisfaction among those who undergo underarm surgery is between 92 and 95 percent. For the head and face, satisfaction is "in the 80 percent range," and, as for feet, "no surgery is good. You can have leg swelling" and other side effects.

Dr. Shende said the biggest potential side effect is compensatory sweating (excessive sweating on the back, chest, abdomen, legs, face, buttocks or feet), usually during mild exercise. "A higher heart rate may happen [but] it is extremely mild and it goes away. Compensatory sweating also levels off."

Because of those possible side effects, Dr. Shende typically operates on only one of the excessively sweating areas.

"I try to treat the worst site [because] the incidence of side effects go up with multiple levels [of surgery]," she said.

Reached at Indiana University of Pennsylvania, Ms. Harris said she's not troubled by side effects. "The sweat has to come out somewhere. It comes out on the torso like every other person. ...

"I hardly think about it anymore. It's like I never had a problem with it. It's definitely helped me with my art classes as well. I can draw and not worry about my fingers smudging the work."

Ms. Harris gave her first post-surgical work, a pencil drawing enhanced by charcoal and tea, to Dr. Shende.

"She was so helpful I thought she should have the first piece," Ms. Harris said.

Mr. Shoemaker now sweats more from his back than he did before his surgery, but he considers it a small price to pay.

"I'm so happy," he said. "It could make you cry talking about it."

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