Management of Compensatory Sweating After Sympathetic Surgery

Thorac Surg Clin. 2016 Nov;26(4):445-451. doi: 10.1016/j.thorsurg.2016.06.009. Epub 2016 Aug 4.


Compensatory hyperhidrosis (HH) is the most common and feared side effect of thoracic sympathectomy, because patients with severe forms have their quality of life greatly impaired. The most well-known factors associated with compensatory HH are extension of manipulation of the sympathetic chain, level of sympathetic denervation, and body mass index. Technical developments as well as the proper selection of patients for surgery have been crucial in reducing the occurrence of severe forms of compensatory HH. Therapeutic options include topical agents, botulinum toxin, systemic anticholinergics, clip removal, and sympathetic chain reconstruction, although the efficacy is not well-established for all the methods.

Keywords: Cholinergic antagonists; Hyperhidrosis; Sweating; Sympathectomy; Sympathetic nervous system.

Publication types

  • Review

MeSH terms

  • Combined Modality Therapy
  • Humans
  • Hyperhidrosis / physiopathology
  • Hyperhidrosis / surgery*
  • Postoperative Complications / physiopathology
  • Postoperative Complications / prevention & control
  • Postoperative Complications / therapy*
  • Sweating / physiology*
  • Sympathectomy* / methods
  • Thoracoscopy