Functional Disorders of the Sympathetic Nervous System


Hyperhidrosis and Facial Blushing

- Hyperreactivity of the Sympathetic Nervous System -


Excessive reactions of the autonomic nervous system may be the underlying cause of a variety of disorders, some of which may be quite distressful for the affected person. These include those dysfunctions of the sympathetic nervous system (SNS) described herein in detail, namely excessive sweating and facial blushing. In the presence of strong stimuli, sweat attacks or blushes may be considered as a physiological, albeit somewhat exaggerated response of the sympathetic nervous system. However, if these disproportionate reactions appear in everyday situations without appropriate triggering factors, there is a risk that these uncontrollable symptoms become a significant problem in many practical activities or when interacting with other people. In extreme cases, the condition may even constitute a hinder for certain professions or lead to severe psychological discomfort and social isolation.

20 years after publishing the first website on the Internet dedicated to hyperhidrosis (, the author has decided to revise the topic integrating synthetically new knowledge gained in the past 2 decades. The articles also represent a resumé of experience and research of the author, after dealing with this issue in over 25 years and having treated several thousand patients with hyperhidrosis or erythrophobia, conservatively and/or surgically. The compilation of this website should be considered as in progress with the aim to gradually expand and update its content.

Special thanks in this regard go to my longtime fellow colleagues in Gothenburg, Ass. Prof. Göran Claes and Ass. Prof. Christer Drott, pioneers in the field of endoscopic surgery on the thoracic sympathetic nervous system, who piqued my interest in it and made me familiar with the original methodology. Important to me was also the cooperation with Dr. Timo Telaranta from Tampere, Finland, who, inter alia, evolved the reconstruction methods and who's extraordinary ability for innovative thinking was really stimulating. Last not least I have to express my gratitude to Prof. Dr. Rieger in Gmunden, a main driving force in the development of the endoscopic approach for lumbar sympathectomy, who gave me extraordinary initial input in this regard. Overall it has been a very interesting task to participate in developing the field of sympathetic surgery and, I am confident it will continue to be stimulating in the future.