Compensatory hyperhidrosis

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Compensatory hyperhidrosis
Illustration of the sympathetic nervous system
Synonyms
Pronounce
Specialty	Dermatology, Neurology
Symptoms	Excessive sweating in areas not previously affected
Complications	Skin infections, Social anxiety disorder
Onset	After surgical sympathectomy
Duration	Long-term
Types	N/A
Causes	Compensatory mechanism after sympathectomy
Risks
Diagnosis	Clinical evaluation
Differential diagnosis	Primary hyperhidrosis, Hyperthyroidism
Prevention
Treatment	Antiperspirants, Botulinum toxin injections, Medications
Medication	Anticholinergics
Prognosis	Variable
Frequency	Common after sympathectomy
Deaths	N/A

A condition characterized by excessive sweating in areas not previously affected, often as a result of surgical intervention.

Introduction

Diagram of the sympathetic nervous system, which is involved in the regulation of sweating.

Compensatory hyperhidrosis is a condition where excessive sweating occurs in areas of the body that were not previously affected. This condition often arises as a side effect of surgical procedures aimed at treating primary hyperhidrosis, such as endoscopic thoracic sympathectomy (ETS).

Pathophysiology

Compensatory hyperhidrosis is believed to occur due to the disruption of the sympathetic nervous system. When the sympathetic nerves responsible for sweating in one area are cut or destroyed, the body may compensate by increasing sweat production in other areas. This is thought to be a result of the body's attempt to maintain homeostasis in its thermoregulatory processes.

Clinical Presentation

Patients with compensatory hyperhidrosis typically report excessive sweating in areas such as the back, abdomen, thighs, or legs. This sweating can be more severe than the original hyperhidrosis and can significantly impact the patient's quality of life.

Management

Management of compensatory hyperhidrosis can be challenging. Treatment options include:

• Topical agents such as aluminum chloride antiperspirants.
• Systemic medications like anticholinergics that reduce sweating.
• Botulinum toxin injections, which can temporarily block the nerves responsible for sweating.
• Lifestyle modifications, including wearing breathable clothing and using absorbent pads.

Surgical Considerations

Patients considering surgical treatment for primary hyperhidrosis should be informed about the risk of developing compensatory hyperhidrosis. The decision to undergo surgery should weigh the potential benefits against the risk of this side effect.

See also

• Hyperhidrosis
• Endoscopic thoracic sympathectomy
• Sympathetic nervous system