Hi everyone,

I’m looking to connect with others managing palmar (hands) and plantar (feet) hyperhidrosis, specifically comparing strong topical antiperspirants and Endoscopic Thoracic Sympathectomy (ETS) surgery.

Living in Thailand's humidity makes daily tasks—like gripping a steering wheel, shaking hands, or wearing sandals—a constant battle. I am weighing my options and would love to hear about your firsthand experiences.

I’m also interested to hear if anyone has consulted with local dermatologists or surgeons at places like Bangkok Hospital Phuket or local aesthetic clinics regarding these treatments.

If you have gone down either of these roads, please drop your thoughts below. I really appreciate your insights!

Cheers,

I can understand. It's terrible to sweat and you can't stop it. Also, it's a psychological issue. The more you're thinking of it the more you're sweating.

ETS can help and it will. It's an easy surgery actually, (if done by experienced surgeons) small incisions under your arms.

My work experience is that you won't sweat as before in those areas, but other areas (a bit) more.

I'm not sure if you wouldn't regret if the sweat runs down your back.

Also, there might be issues with your eyelids. Your heart might beat slower or the chance of Pneumothorax. Botox is another option (to repeat all 6 months) to stop sweating.

Cave: if you're sweating all over your body, ETS is not for you (see side effects).

Then go for Aluminium chloride products

What is your age, insulin management/flexibility, and blood pressure?

If you drastically lower your insulin resistance for example, there is a good chance it will reduce the severity and might eliminate it completely. THat's where I would focus.

3 hours ago, atpeace said:

What is your age, insulin management/flexibility, and blood pressure?

If you drastically lower your insulin resistance for example, there is a good chance it will reduce the severity and might eliminate it completely. THat's where I would focus.

Another reason why the body might be sweating is renal overload. For a long time in Thaiand I thought I had hyperhidrosis, until it was found out that my kidneys had nearly completely shut down due to constant dehydration and very high salt intake.

After the removal of a very large kidney stone, fixing my body weight and fluid intake, the sweating (and at times rather horrific body odour) has reduced to a normal state.

2 hours ago, jts-khorat said:

Another reason why the body might be sweating is renal overload. For a long time in Thaiand I thought I had hyperhidrosis, until it was found out that my kidneys had nearly completely shut down due to constant dehydration and very high salt intake.

After the removal of a very large kidney stone, fixing my body weight and fluid intake, the sweating (and at times rather horrific body odour) has reduced to a normal state.

Yep, metabolic health is the cure until you reach the point of no return. I take loads of extra sodium but as I age, I have determined I don't need as much. We all have different genetics and lifestyles so figure out what works for you as "you" did. People look for quick fixes like surgeries or meds but why not fix the cause :)

5 hours ago, D Peter said:

I can understand. It's terrible to sweat and you can't stop it. Also, it's a psychological issue. The more you're thinking of it the more you're sweating.

ETS can help and it will. It's an easy surgery actually, (if done by experienced surgeons) small incisions under your arms.

My work experience is that you won't sweat as before in those areas, but other areas (a bit) more.

I'm not sure if you wouldn't regret if the sweat runs down your back.

Also, there might be issues with your eyelids. Your heart might beat slower or the chance of Pneumothorax. Botox is another option (to repeat all 6 months) to stop sweating.

Cave: if you're sweating all over your body, ETS is not for you (see side effects).

Then go for Aluminium chloride products

Thank you so much for taking the time to share these facts about the treatments. I really appreciate how clear, straightforward, and detailed your insights are.

To give you a bit of background, my 19-year-old Thai niece suffers from severe hyperhidrosis in both her hands and feet, which ranges from mild to severe at random on a daily basis. She recently consulted a specialist at PhyaThai 1 Hospital, who recommended starting with oxybutynin tablets.

She is quite hesitant about the tablets because she is worried about dryness issues in other parts of her body, but she plans to give them a try next month for insurance reasons. Naturally, she will stop taking them immediately if she experiences any adverse reactions or allergies. Despite being aware of compensatory sweating in other areas, she currently feels that ETS surgery is the best approach to permanently stop the sweating in her hands and feet.

By the way, I wanted to ask—is your professional background or work experience based in Thailand or elsewhere? Also, if you don't mind sharing, how long have you been working in this field?

Thanks again for your valuable input and warnings regarding the procedure.

6 minutes ago, Nabbiex said:

Thank you so much for taking the time to share these facts about the treatments. I really appreciate how clear, straightforward, and detailed your insights are.

To give you a bit of background, my 19-year-old Thai niece suffers from severe hyperhidrosis in both her hands and feet, which ranges from mild to severe at random on a daily basis. She recently consulted a specialist at PhyaThai 1 Hospital, who recommended starting with oxybutynin tablets.

She is quite hesitant about the tablets because she is worried about dryness issues in other parts of her body, but she plans to give them a try next month for insurance reasons. Naturally, she will stop taking them immediately if she experiences any adverse reactions or allergies. Despite being aware of compensatory sweating in other areas, she currently feels that ETS surgery is the best approach to permanently stop the sweating in her hands and feet.

By the way, I wanted to ask—is your professional background or work experience based in Thailand or elsewhere? Also, if you don't mind sharing, how long have you been working in this field?

Thanks again for your valuable input and warnings regarding the procedure.

To start with my work experience. More than 40 years in EU in different hospitals. not in Thailand.

Oxybutynin is highly effective when it comes to excessive sweating. It was made for treating an overreactive bladder. That's why you are reluctant, aren't you? It blocks certain signals sent to sweat glands, preventing them from producing sweat. (in simple words)

Side effects are dry mouth, dizziness, heat intolerance, that means she will have to be very careful with temperatures and have to drink a lot. 2,5mg daily might be a start. The benefit will be shown within days, full after 4 weeks. (possible to increase the dose)

59 minutes ago, D Peter said:

To start with my work experience. More than 40 years in EU in different hospitals. not in Thailand.

Oxybutynin is highly effective when it comes to excessive sweating. It was made for treating an overreactive bladder. That's why you are reluctant, aren't you? It blocks certain signals sent to sweat glands, preventing them from producing sweat. (in simple words)

Side effects are dry mouth, dizziness, heat intolerance, that means she will have to be very careful with temperatures and have to drink a lot. 2,5mg daily might be a start. The benefit will be shown within days, full after 4 weeks. (possible to increase the dose)

Thank you so much for sharing your background. It is no wonder your insights are so incredibly clear and valuable—over 40 years of hospital experience across the EU is truly impressive and reassuring to hear!

Regarding the dosage, your point about starting with 2.5mg makes perfect sense. I was actually quite surprised when the delivery arrived, as her specialist prescribed 5mg daily right out of the gate.

Starting directly on 5mg does sound a bit harsh and increases the likelihood of dealing with intense side effects like dry mouth or heat intolerance, especially for a 19-year-old. Do you think it would be advisable for her to cut the 5mg tablets in half for the first week or two to let her body adjust gently, or is it strictly necessary to follow the 5mg prescription from day one?

Your guidance on this would be greatly appreciated before she has her start date next month!

16 hours ago, Nabbiex said:

Thank you so much for sharing your background. It is no wonder your insights are so incredibly clear and valuable—over 40 years of hospital experience across the EU is truly impressive and reassuring to hear!

Regarding the dosage, your point about starting with 2.5mg makes perfect sense. I was actually quite surprised when the delivery arrived, as her specialist prescribed 5mg daily right out of the gate.

Starting directly on 5mg does sound a bit harsh and increases the likelihood of dealing with intense side effects like dry mouth or heat intolerance, especially for a 19-year-old. Do you think it would be advisable for her to cut the 5mg tablets in half for the first week or two to let her body adjust gently, or is it strictly necessary to follow the 5mg prescription from day one?

Your guidance on this would be greatly appreciated before she has her start date next month!

I recommend to start with 2,5 mg daily for 2-3 weeks by monitoring side effects.

If sweating will be significantly decreased it's fine. If not it's easy to go to 5 mg.

Not ad infinitum, but a few months only until your niece will have build up confidence. (!) I hope she will make it without medication. She's young and her hormones might change in the future (giving birth). Watch her with care. I know you will.

49 minutes ago, D Peter said:

I recommend to start with 2,5 mg daily for 2-3 weeks by monitoring side effects.

If sweating will be significantly decreased it's fine. If not it's easy to go to 5 mg.

Not ad infinitum, but a few months only until your niece will have build up confidence. (!) I hope she will make it without medication. She's young and her hormones might change in the future (giving birth). Watch her with care. I know you will.

Thank you 🙏

22 hours ago, D Peter said:

To start with my work experience. More than 40 years in EU in different hospitals. not in Thailand.

Oxybutynin is highly effective when it comes to excessive sweating. It was made for treating an overreactive bladder. That's why you are reluctant, aren't you? It blocks certain signals sent to sweat glands, preventing them from producing sweat. (in simple words)

Side effects are dry mouth, dizziness, heat intolerance, that means she will have to be very careful with temperatures and have to drink a lot. 2,5mg daily might be a start. The benefit will be shown within days, full after 4 weeks. (possible to increase the dose)

It also dries out intimate areas. That's also a concern.

On 6/24/2026 at 5:49 PM, jts-khorat said:

Another reason why the body might be sweating is renal overload. For a long time in Thaiand I thought I had hyperhidrosis, until it was found out that my kidneys had nearly completely shut down due to constant dehydration and very high salt intake.

After the removal of a very large kidney stone, fixing my body weight and fluid intake, the sweating (and at times rather horrific body odour) has reduced to a normal state.

It is such a great relief to hear that your body is back to normal and that you’ve found the root cause of what you were going through! Dealing with all of that—especially thinking it was hyperhidrosis for so long—must have been incredibly tough.

Given what you went through with the dehydration and the kidney stone, staying on top of your hydration is definitely going to be key to keeping your kidneys healthy moving forward.

Make sure to keep drinking plenty of water daily, and take good care of yourself!