I have seen that a pharmacist can help with hyperhidrosis (excessive sweating). According to the NHS website you can buy things without a prescription which can help, such as:

  • stronger antiperspirants instead of deodorant
  • armpit or sweat shields to protect your clothing
  • foot powders for sweaty feet
  • soap substitutes that are more gentle on your skin.

But what if they don't help?

Surgically, I have heard of endoscopic bilateral thoracic sympathicolysis (EBTS)

Endoscopic bilateral thoracic sympathicolysis (EBTS) is an effective and minimally invasive procedure used for patients with primary hyperhidrosis (Ramos, et al. 2006; Ureña, et al. 2009).

However, there are a fair few risks involved from what I understand, where:

Thoracic sympathectomy will change many bodily functions, including sweating,[14] vascular responses,[15] heart rate,[16] heart stroke volume,[17][18] thyroid, baroreflex,[19] lung volume,[18][20] pupil dilation, skin temperature and other aspects of the autonomic nervous system, like genitourinary functions and the essential fight-or-flight response (Wikipedia).

The procedure can also lead to Horner's Syndrome or Harlequin Syndrome and I have found that for 92% of patients (National Institute for Health and Care Excellence [NICE], 2014), the surgery can cause them to sweat more heavily than the hyperhidrosis did, defeating the object of the surgery while risking more serious complications all surgeries carry.

So, what other options are available (if any) for those who suffer from generalised primary (idiopathic) hyperhidrosis?

Generalised meaning all over the body rather than localised to hands, feet or armpits; and idiopathic meaning of no known underlying medical cause such as obesity, menopause, a tumor, diabetes mellitus, or hyperthyroidism (overactive thyroid gland).

Are there alternatives to EBTS which can help with hyperhidrosis, and maybe with less risk to other functions of the autonomic nervous system?


NICE (2014). Endoscopic thoracic sympathectomy for primary hyperhidrosis of the upper limb: Interventional procedures guidance [IPG487] https://www.nice.org.uk/guidance/ipg487

Ramos, R., Moya, J., Morera, R., Masuet, C., Perna, V., Macia, I., Escobar, I., & Villalonga, R. (2006). An assessment of anxiety in patients with primary hyperhidrosis before and after endoscopic thoracic sympathicolysis. European journal of cardio-thoracic surgery, 30(2), 228–231. https://doi.org/10.1016/j.ejcts.2006.05.018

Ureña, A., Ramos, R., Masuet, C., Macia, I., Rivas, F., Escobar, I., Villalonga, R., & Moya, J. (2009). An assessment of plantar hyperhidrosis after endoscopic thoracic sympathicolysis. European journal of cardio-thoracic surgery 36(2), 360–363. https://doi.org/10.1016/j.ejcts.2009.02.062


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