# What is compensatory sweating and what are its risks after endoscopic thoracic sympathectomy (ETS)? Canonical page: https://clinicsjo.com/en/faq/compensatory-sweating-what-it-is-and-its-risks Language: en Category: dermatology Publisher: ClinicsJo Published: 2026-09-13T17:52:53.368Z Content updated: 2026-09-13T17:52:53.368Z Translation (ar): https://clinicsjo.com/ar/faq/compensatory-sweating-what-it-is-and-its-risks Compensatory sweating is an increase in perspiration that occurs in different areas of the body that did not previously suffer from excessive sweating, and it is a potential side effect after undergoing endoscopic thoracic sympathectomy (ETS) surgery [\[3\]](). This surgery aims to treat severe hyperhidrosis, especially in the hands or face, by cutting or destroying the sympathetic nerves responsible for stimulating sweat glands in those areas [\[3\]](). As a reaction, the body may compensate for the lack of sweating in the treated areas by increasing its secretion in other areas, such as the torso [\[3\]](). Sweating in other areas of the body is a potential problem after the operation and may be bothersome to some patients. It is important to discuss this before making a decision and to review other options, which may include antiperspirants or botulinum toxin injections, depending on the sweating area and the assessment of the treating team [\[4\]](). ## Understanding compensatory sweating and its locations Compensatory sweating is one of the main challenges patients face after thoracic sympathectomy surgery. Compensatory sweating may appear in areas such as the torso (back and chest) [\[3\]](). Some people may find that excessive sweating in new areas affects their quality of life, and it is essential to discuss these potential risks with the doctor before deciding to undergo surgery to weigh the expected benefits against potential side effects [\[3\]](). ## Other surgical risks of thoracic sympathectomy In addition to compensatory sweating, thoracic sympathectomy (ETS) carries general and specific surgical risks, given that it is performed under general anesthesia [\[3\]](). These risks include [\[3\]](): - Collection of blood in the chest (hemothorax) or collection of air in the chest (pneumothorax). - Horner syndrome, a rare condition that may cause drooping of the eyelid or reduced sweating on one side of the face [\[3\]](). - Potential injury to nerves or blood vessels during surgery. - Bradycardia (slow heart rate). - Pneumonia. It is important for the patient to be aware of these risks and discuss them with the surgeon before the procedure [\[3\]](). ## Managing compensatory sweating If you suffer from hyperhidrosis, it is important to explore all non-surgical treatment options first. You can learn more about these options in our article on [Hyperhidrosis: When is it a medical problem and how can it be treated? (Arabic)](). If compensatory sweating occurs after thoracic sympathectomy, some guidelines can be followed: - Regular follow-up with the surgeon to evaluate the condition and receive appropriate recommendations. - Use of strong topical antiperspirants, under medical supervision, for the new areas where excessive sweating appears. - Wearing loose clothing made of natural fabrics that allow good ventilation and absorb moisture. Immediate medical attention should be sought if any symptoms indicating serious surgical complications appear, such as sudden difficulty breathing, severe chest pain, or signs of severe infection at the surgical site. These symptoms require urgent medical assessment [\[3\]](). ## Medical references - [Endoscopic thoracic sympathectomy: MedlinePlus Medical Encyclopedia]() - [Thoracoscopic Sympathectomy (TES) - Manchester Royal Infirmary]() General health education; not a substitute for individualized clinical assessment. Citation URL: https://clinicsjo.com/en/faq/compensatory-sweating-what-it-is-and-its-risks#answer