Compensatory Sweating

Asian Skin Rejuvenation at a glance

  • Best Results7 to 21 days
  • Treatment RecoveryNA
  • Procedure TimeNA
  • Skin SpecialistDermatologist
  • Duration of ResultsVariable
  • AnaestheticNA
  • Back to WorkNA
  • Cost$

Compensatory Sweating

Compensatory hyperhidrosis is a common event that occurs after ETS or endoscopic thoracic sympathectomy. This is a form of rebound sweating that can occur on parts of the body that were not affected from sweating like sweaty palms. This form of excessive sweating can occur on the trunk, underarms, limbs, face, & scalp. Once compensatory hyperhidrosis occurs, it often persists. Effective treatments are possible. Dermatologists use a combination of creams, tablets and in some cases anti-sweat injections to help reduce the inconvenience of compensatory sweating.

FactsFacts On Compensatory Hyperhidrosis

  • This form of excessive sweating commonly occurs after endoscopic thoracic surgery
  • Compensatory excessive hyperhidrosis is also called reflex or rebound sweating
  • A combination of treatments including antiperspirants, tablets, & compounded creams can manage most cases of compensatory sweating
  • Treatment for compensatory sweating often needs to be lifelong

What is compensatory hyperhidrosis?

Compensatory hyperhidrosis is also called reflex or rebound sweating and most commonly occurs after ETS surgery. ETS surgery or endoscopic thoracic sympathectomy is a type of surgery for excessive sweating of the hands, underarm sweating, or facial sweating. Compensatory sweating occurs in areas that were not affected by sweating before a procedure or event. Once sweating develops, it usually persists.

How common is compensatory sweating?

Compensatory hyperhidrosis is commonly seen after Endoscopic Thoracic Sympathectomy. Most patients undergo ETS for excessive sweating of the hands, or less commonly excessive underarm sweating, or facial sweating. Rebound or reflex sweating occurs several weeks or months after ETS surgery. The quoted incidence ranges from 20 to 70%.

Rare causes of compensatory hyperhidrosis include nerve trauma, brain disorders, myelopathy and thoracic disorders.

What areas are commonly affected by this pattern of sweating?

The most common areas involved in excessive rebound sweating is the back, chest, underarms and trunk, rarely compensatory hyperhidrosis can affect the neck & face. In extreme cases it can become generalised, and patients can sweat everywhere.

Davin’s Viewpoint on Compensatory Sweating

Compensatory or rebound sweating is commonly encountered by dermatologists. Most patients present secondary to ETS or endoscopic thoracic sympathectomy. The common story is that they have surgery for excessive and severe sweating of the hands, then a few weeks or months later, present with areas of excessive sweating elsewhere, most commonly on the back or trunk. Most patients do not regret having surgery in the first place, as excessive sweating on the hands is both more challenging to treat and has a higher impact on lifestyle than compensatory sweating elsewhere. The second most common presentation is that patients had ETS for facial sweating and blushing. Very rarely do patients have ETS for underarm sweating, now that effective treatments such as sweat stopping treatments are available under the PBS.

Compensatory excess sweating can be challenging to treat, however most patients respond with a combination of antiperspirants, prescription compounded creams, and tablets. Focal areas can also be injected with Botox treatments, especially if it involves small areas on the back/trunk, as well as the forehead and scalp area.

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