Ask a doctor

Can Miradry Develop Compensatory Sweating or Increasing Sweating in Others Parts of the Body ?

Can Miradry Develop Compensatory Sweating or Increasing Sweating in Others Parts of the Body ?

Doctor Answers 12

Compensatory sweating with miraDry has been seen in at least 1 patient

We are aware of at least 1 case reported to the company (Miramar) about compensatory sweating in a patient who had the miraDry procedure by a physician in NY City.

I have taken care of hyperhidrosis patients since 1999 in a comprehensive Center for Exessive Sweating and provide every type of treatment for hyperhidrosis. I have seen patients develop compensatory sweating with the use of Hypercare (rare, but it does happen). I have seen patients develop compensatory sweating with Botox injection in the underarms (rare, but it can happen). I have seen groin sweating in someone who was being treated with oral Robinul (rare, but it happens).

So, compensatory sweating is most well described with ETS (sympathectomy or STITCH procedure) but it can rarely happen with other hyperhidrosis procedures.

Having said that, miraDry is an excellent procedure if you are looking for definitive treatment for an annoying problem called axillary hyperhidrosis (underarm sweating) and compensatory sweating can occur but is very very unlikely to occur after the miraDry procedure.

You cannot predict who will develop compensatory sweating. If you could, the sympathectomy procedure would be a perfect procedure - but it isn't - if it were, you could predict who would get compensatory sweating and NOT OFFER the procedure to them. Unfortunately, we cannot predict who would get compensatory sweating and who will not - it is a very very small risk for patients receiving miraDRY and much higher risk if you sign up for thoracic sympathectomy.

No compensatory sweating

Although miraDry is getting a lot of attention recently, it has actually been around for a while. It has been extensively studied and there is no cancer association. The FDA has cleared it for safe use as well. The microwave energy only penetrates 4-5mm in depth and heats up and destroys the sweat and odor glands. The energy does not reach lymph nodes or deeper structures and it in non-ionizing radiation (the safe kind, like radiowaves). I have had the procedure done myself and it has truly been a gift. One and done for 80% of people! In the long term, much more cost-effective than Botox which has to be repeated every 3-6 months. There is no compensatory sweating with miraDry.  Let us know if we can help in any way.

Sheila S. Nazarian, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 34 reviews

Very very unlikely to develop compensatory sweating...

The answer is very unlikely....much less than 1%. Compensatory HH or rebound sweating is notoriously common with resection of the T2 downwards ganglion, especially for sweaty hands. This rebound sweating was seen in up to 50 % of patients. 
I have NOT seen rebound sweating with miraDry, but have seen 3 cases with Botox for underarm sweating. I ve done several thousand Botox underarm sweating injections since 2002, and only noted possibly 0.1% cases. This is poorly understood. 

One theory is that when sweating stops in one place, patients tend to notice it more in other places, eg. Forehead or scalp sweating. Very hard to distinguish rebound sweating, or sweating already there in the first place. 

Bottom line, miraDry has a much, much lower chance of compensatory HH compared to surgery or ETS. 


Dr Davin Lim
Cosmetic and Laser Dermatologist
Brisbane, Australia

Davin Lim, MBBS, FACD
Brisbane Dermatologist
5.0 out of 5 stars 20 reviews

You might also like...


In our office we have never seen any reports of compensatory sweating after a MiraDry treatment.

Dr. Grant Stevens Marina Plastic Surgery Associates Marina del Rey, CA The Institute

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.5 out of 5 stars 95 reviews

Very unusual - we never seen it in our patients (treated over the last 3 years)

It is very unusual to develop compensatory sweating with Miradry.

Miradry has a very high success rate and it’s been a life-changing procedure for all of our patients. After performing Miradry for more than 3 years now we haven’t had any cases with compensatory sweating. Only 4% of your body’s sweat glands are located under your arms. By destroying such a small amount of sweat gland your body won’t develop compensatory sweating. In addition, the treatment is very localized and it does not affect any other body areas.

MiraDry and compensatory sweating

Only one case of secondary sweating, also known as compensatory hyperhidrosis, has been reported out of the thousands of miraDry procedures performed to date.  Given the nature of the miraDry procedure, which uses microwave technology to non-invasively eliminate sweat glands, as opposed to invasive surgical procedures that sever nerve connections, compensatory hyperhidrosis is a highly unlikely and very rare event with miraDry.

Joshua L. Fox, MD
Long Island Dermatologic Surgeon
5.0 out of 5 stars 12 reviews

Compensatory sweating with MiraDry

There are no studies showing increased compensatory sweating as has been reported with surgical sympathectomy.  I have traditionally done a surgical axillary sweat gland removal using an endoscopic shaving technique, and there is no compensatory sweating using this modality since I am destroying the sweat glands.  The same is true for MiraDry which uses microwave energy to destroy the sweat glands.

We have not seen compensatory sweating from miradry

Compensatory sweating from miradry has not been reported.  But one needs to keep in mind that we do not have five or ten year data available.  I have actually treated compensatory sweating in one patient who developed it in the armpits after surgery, successfully through the miradry procedure.  I would guess that this side effect, if it happens at all, would be extremely rare.

Cameron Rokhsar, MD
New York Dermatologic Surgeon
4.5 out of 5 stars 33 reviews

Probably not

Since this is a localized treatment, it is unlikely that it can cause compensatory sweating.  We have not seen any in the patients we've treated so far.

Laura E. Skellchock, MD
Boca Raton Dermatologic Surgeon
4.5 out of 5 stars 21 reviews

Compensatory sweating after miraDry is extremely rare

Compensatory sweating after miraDry is extremely rare. Your body contains four-million sweat glands with only about two percent located in the underarms. Eliminating the majority of this two percent will not affect the body's ability to cool itself.

Suzanne Kilmer, MD
Sacramento Dermatologic Surgeon
4.5 out of 5 stars 4 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.