What is Compensatory Sweating and 2 Benefits of ETS

When people sweat excessively in any part of the body they will always be searching for a way to stop the sweating, which can be terribly annoying and interfere with your daily life.

In this modern world, solutions have been found to stop excessive sweating, but sadly, some of these methods have irreversible secondary effects that nobody wants to live with. In this post, I will talk about what is compensatory sweating all about and give you some tips to prevent it and what to do if you have it.

Compensatory sweat
You think about what compensatory sweating is and why it happens.
Photo by Keren Perez on Unsplash

You’re not alone in dealing with sweat-related problems. I have been managing and dealing with hyperhidrosis for over 2 decades now so I do know how hard it is. Read my story here.

What is Compensatory Hyperhidrosis

Compensatory hyperhidrosis is an excessive sweating condition that happens after an endoscopic thoracic sympathectomy (a.k.a. ETS).

There are people that suffer from primary hyperhidrosis that take the risk to undergo a surgery in which the nerves that control sweating are completely removed.

The surgeon will make a small incision between the ribs and try to find the nerves that go bilaterally along the vertebral column and find the nerve that is responsible for the area where excessive sweating occurs.

Once these nerves are found, he will then go on and destroy them so that no signals can travel anymore to the sweat glands to trigger sweating.

After this surgery people do not sweat anymore on that part that was affected, namely armpits, face/scalp, feet, or others.  This procedure is 100% effective and leaves people with no more excessive sweating in those areas of the body.

Since these nerves are destroyed, the affected part of the body now starts to believe that it is always too hot, which is when it starts to sweat excessively in the rest of the body.  Literally, the sweat glands that are still “working” are compensating for what they have lost.

It is still unclear what exactly happens in patients that have undergone ETS. Science has yet to discover why compensatory sweating only affects around 80% of patients that have undergone ETS.

Benefits of ETS

Anyone suffering from excessive sweating should only take ETS as the last resort to fix the problem because there are a few risks involved.  However, there are also benefits.

1. Improves the quality of life

Suffering from hyperhidrosis interferes with your daily life.  Sweating excessively in any part of your body is uncomfortable at the least, but it also embarrassing.

Because you are afraid that you will sweat, you sweat even more which makes things worse.  You are always afraid of social gatherings, family reunions, making public appearances, etc.  

You dread the moment when you will give somebody a hug because you are completely drenched in your armpits, or you fear that college test because your sweaty hands will smear over the paper.  

Since ETS stops your excessive sweating in some body parts, you will have that long-desired freedom from sweating.

2. It is Effective in Some Parts of the Body

For some unknown reason, ETS is only effective in some body parts.

Hands and face/scalp are the ones where it is most effective and gives long-lasting results.

However, research has to be done on why there are mixed results for armpit sweating.  Some patients have had success with it, and for some patients, it has not brought the longed-for effect.

Also, ETS is known not only not as effective for groin, butt, back, and feet, it is advised not to do it, as you will see below.

So, while there are benefits, you must carefully talk this through with your care provider in order to make sure it is really an option for you.

Risks of ETS

While there are some risks of an ETS, for some the benefits outweigh the risks.  You still want to take a closer look and be well informed before you undergo such a delicate procedure.

1. Compensatory Sweating

As said, over 80% of patients that have undergone ETS report compensatory sweating.  Around half of these say that their quality of life has improved regardless of compensatory sweating.

Around half of these patients wish they would have never undergone the procedure because sweating is worse after the surgery than it was before.  Only that they are sweating on other body parts.

Some doctors have used a clip to just block the nerves instead of making the nerve damage irreversible.  Patients that have had a bad experience with ETS sometimes opt to reverse the surgery by having the clip removed.

But it has been widely reported that it is not always effective since the nerves have been damaged to some degree.

The risk of compensatory sweating, as you can see, is very high.  Some researchers even say that everybody that has undergone ETS will develop a certain level of compensatory sweating.

2. Scarring

The risk of any medical intervention is the scars that are left behind because of the multiple incisions that the surgeon will make.

3. Damaged nerves

The nerves that control sweating are very close to other very important nerves and the surgeon can always make a mistake and damage other nerves, leading to other problems.

For example, the phrenic nerve, which aids in breathing is one of those that can be affected when ETS is applied to palmar and facial sweating.

The other nerves that can be affected, especially in men, are the nerves that aid fertility.  When these nerves are damaged, men are left impotent, and that is irreversible.

4. Hypohidrosis

When you undergo ETS, you are literally anhidrotic, which means that you are suffering from the impossibility to sweat in certain areas of your body.

Anhidrosis, also known as hypohidrosis is a condition where people cannot sweat at all and there are some risks involved with this, like hyperthermia, migraines, or even a heat stroke.

For example, if you stop your sweating in your head, and arms, your upper body cannot thermoregulate itself anymore.  Through sweating, heat evaporated with each drip of sweat.  Although the risk of hyperthermia and a heat stroke is very low, it is well worth considering it.

Some other risks include infection, air trapped between the lungs, drooping eyelids, among others.

What Can You Do About Compensatory Sweating

If you have undergone ETS or plan to do so and you do not know what to do with compensatory sweating, in this section, I will share a few things that you can do to reduce the embarrassing consequences of excessive sweating.

1. Prevent ETS

It sounds contradictory, but if you are thinking of undergoing ETS, I strongly advise you not to do so.  Excessive sweating is manageable.  I have lived with severe armpit sweating for years, and I know exactly the battles that you go through.

I have found my solution and I would never undergo this procedure because if sweating should be worse in other body parts than it is now, I do not want that at all.

So, if you have not undergone ETS, please read further down to read more about what I have done with my excessive sweating problem.

And if you have already gone through ETS, there are some things that can actually give you relief from compensatory sweating.

2. Iontophoresis Treatment

A rather new treatment that has been developed is iontophoresis.  It is a machine that sends electric waves through feet and hands water bath into your body and reduces your sweating.

It is not yet well understood what exactly iontophoresis does, but people that have found the correct balance of how to use it properly, have found it to be very effective.

Especially those patients that have undergone ETS report that iontophoresis is among the most effective treatment that they have found for compensatory sweating.

3. Botox Injections

Initially, Botox was not used for excessive sweating, but since it was widely and effectively used in the cosmetic industry, it has been taken as an effective method to stop excessive sweating.

Neurotoxins are injected in the affected area which blocks the sweat glands completely.

However, the problem with Botox is that it causes some degree of compensatory sweating since your body cannot sweat it out where it was supposed to sweat it.  Therefore, Botox is probably not the most effective for compensatory sweating.

Also, you have to know that Botox injections would not be done to all body parts.

Something else to take into account when considering Botox injections is the cost.  Botox injections last around 4-6 months, at which point you have to go through this costly procedure again.

4. Chose your Clothes Wisely

No matter where you sweat the most, wearing the right clothes is important.  Hyperhidrosis sufferers have it figured out quite easily that cotton clothes soak up the sweat better than any other type of fabric.

From underwear to socks to outer layers of clothes, you do not want to wear polyester or other types of fabrics.  Cotton is a moisture-wicking agent and helps greatly.  Although it does not reduce sweating, it definitely aids the problem.

I personally love undershirts like the Ejis undershirt armpit sweating problems. For women, they might like using Numi as it is sleeker and can even be worn by itself. I also love using the multifunctional headwear that can be worn in 16 different ways as it keeps the sweat away from my eyes.

I think using underwear that prevents ugly and embarrassing sweat stains is well worth the price and I prefer that from having to deal with excessive compensatory sweating because of ETS.

5. Medication

Medication is another thing you can do to get relief from compensatory sweating or your regular hyperhidrosis.  The most common and effective sweat stoppers are glycopyrrolate and oxybutynin.

Drugs block the neurotransmitters that signal the sweat glands whenever your body tells it to cool down or whenever you are highly stimulated.

The negative side of drugs is the side effects that they always leave behind.  There are some well-known side effects that I do not plan to elaborate on in this post, but a dry mouth, dizziness, nausea, are among the common side effects, which is why drugs are also one of the last resorts to go to.

6. Natural remedies

Natural remedies are the least favorite and effective for hyperhidrosis sufferers.  Although they can be somewhat effective, they do not do enough to reduce the embarrassment that excessive sweating causes.

Among the common natural remedies, you can find drinking more water, black and green teas, tomato juice, lemon juice, baking soda, among others.

7. Find the Cause of Excessive Sweating

Excessive sweating is not always primary hyperhidrosis, but can also be secondary hyperhidrosis, which is when there is an underlying health issue that causes the sweating.

Thyroid disorders, obesity, menopause, heart-related issues, anxiety disorders, diabetes, different medications are a few of the most common triggers of excessive sweating.

Some sufferers of generalized (secondary) hyperhidrosis never find out what their problem really is and they do think that they suffer from primary hyperhidrosis.

Many causes of secondary hyperhidrosis are treatable and can help you with your excessive sweating, but for others, there is not much you can do about it.

It is very important that you find the cause for your excessive sweating and understand what you can and should do about it.

8. Clinical Strength Antiperspirants

My personal favorite solution to either excessive sweating or compensatory sweating is using clinical strength antiperspirants because they stop your sweating temporarily.

Antiperspirants contain aluminum chloride, which also blocks your sweat glands, but only for 4-10 days, depending on your body and the strength of the antiperspirant.

After that, your sweating will be normal again, which is a cool thing.  You can choose whether you want to apply the product or if you do not need it.

ETS is irreversible and antiperspirants will only block your sweat glands temporarily.

However, if you have compensatory sweating, you could get relief by using clinical strength antiperspirants whenever you think your sweating will be at its worst.

You might be skeptical about using aluminum chloride, but you can rest assured that there is not much evidence to prove that it is harmful to your body.

In fact, you take in more aluminum chloride through your foods than you can accumulate in your armpits.  Besides, you only apply these once or twice a week.

My favorite clinical strength antiperspirant is Sweatblock, which I have used for years and is always effective when I use it correctly.

Sweatblock is thought for the armpits, but you can also apply in other body parts effectively.  In fact, Sweatblock has more products specific to different parts of the body.


Concluding, you just found out what compensatory sweating is, and what you can do about it if you suffer from it.

Compensatory sweating is as uncomfortable and embarrassing as primary hyperhidrosis (a.k.a. focal hyperhidrosis) because it will be visible to those around you.

So what is the difference between sweating excessively in your armpits or on your back?  What do you prefer?  Most likely none.

Therefore, undergoing a procedure like ETS is something I do highly recommend to prevent.  It is better to try finding other solutions to the problem of excessive sweating.

But if you have done ETS and you suffer from compensatory sweating, you will find relief in the fact that there is still something you can do about this problem.

If you found an answer to your question, or you have another question, please leave me a COMMENT below.  I will be happy to interact with you and share my experiences and knowledge with you.

Also, please share with your loved ones who could benefit from this.


Ready to Make a Change Now?

My name is Oscar and I am the founder and director of Stop-Sweating-Now.com and have been researching and writing about hyperhidrosis for many yearOscars.

I have been sweating excessively for the better part of my life.  I looked for solutions for well over a decade, but I never found anything that lasted.

It all started when I was around 14 years of age, when I suddenly found out that I was sweating more in my armpits than I should.  At first I thought it was something that would go away soon, but I was wrong.

I had given up hope and accepted to live the rest of my life being embarrassed with ugly sweat stains in my armpits.

However, after a few years of not searching for any solutions anymore, I gave it another shot.  And I found what finally gave me the freedom I had longed for so many years. 

After finding a solution to my problem, I decided it was important to shout out my message to those that are suffering from what I had lived with so many years.

My goal is to help people find their freedom from sweating by sharing my expertise because hyperhidrosis is an underdiagnosed condition.

People don’t know that it is a medical term and can be treated effectively.

That is why I am here: Sharing with you what I know, what works and what does not work.

Want to learn more about what I did? Click below!

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