Will Miradry Successfully Treat Severe Compensatory Sweating Caused by ETS?

I'm a 30 year old female and I've had ETS done in 1999 for palmar hyperhidrosis. Now my hands and face don't sweat, but literally every other part of my body does. I can't use strong, prescription antiperspirants on my armpits (like Klima, Odaban etc), as my skin is extremely sensitive, especially after I've shaved. Medication also has no effect: neither prescription meds (like Oxybutynin) nor natural homeopathic remedies. Also, any idea when Miradry will be available in South Africa? Thank you!

Doctor Answers 8

Miradry options for the underarms and compensatory sweating

Miradry is an excellent longterm treatment for underarm sweating. I have performed the procedure in a subset of patients who have had compensatory sweating from ETS and the results are excellent. 

Dr. Karamanoukian 
Los Angeles

Los Angeles Plastic Surgeon
4.8 out of 5 stars 94 reviews

In theory - YES...miraDry should work

Yes, it should work because the theory of miraDry is to target the eccrine glands, and not the nerves that stimulate sweating. 
miraDry permanently destroys the cause of sweating- ie. overactive eccrine or sweat glands. 2 treatments spaced 3 months apart reduces sweating to that area. Note- miraDry is only approved for sweating of the underarms and NOT on the palms/soles/ other areas. 

all the best

DR Davin S. Lim
Laser and Cosmetic Dermatologist. 

Davin Lim, MBBS, FACD
Brisbane Dermatologist
4.7 out of 5 stars 77 reviews

MiraDry will treat compensatory sweating of the armpits caused by ETS

One of the unfortunate side effects of ETS is compensatory sweating.  MiraDry will decrease sweating in the armpits, whatever the cause.  However, it only works in the treated area (armpits).  Of note: with MiraDry, there is no side effect of compensatory sweating.

Melissa Chiang, MD, FAAD
Houston Dermatologic Surgeon
5.0 out of 5 stars 12 reviews

Miradry for underarms

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. Let us know if we can help in any way.

Sheila S. Nazarian, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 56 reviews

MiraDry and compensatory sweating

The miraDry procedure should work for any type of excessive sweating, regardless of the cause.  To date, miraDry is FDA-approved for treating excessive sweating in the armpit area only.  The miraDry handpiece is specifically designed to fit against and apply slight suction to the shape of an armpit.  Even if you were to attempt it on other parts of your body, you may not be able to get enough suction to ensure an adequate treatment.  Other treatment options available for excessive sweating elsewhere on the body include topical medications, oral medications and neuromodulator injections such as Botox, Dysport and Xeomin. 

Joshua L. Fox, MD
Long Island Dermatologic Surgeon
4.9 out of 5 stars 20 reviews

Compensatory hyperhidrosis caused by ETS

I strongly recommend against ETS (endoscopic thoracic sympathectomy) because the subsequent compensatory hyperhidrosis is exceedingly prevalent and unpredictable. While MiraDry for axillary hyperhidrosis has not linked to compensatory hyperhidrosis, it is not approved by the FDA nor is it sanctioned by the manufacturer to be used outside of the armpit areas. Better option may be utilization of Cynosure PrecisionTx (formerly known as SideLaze) where 1440nm laser energy gets delivered underneath skin for effective and safe ablation of eccrine sweat glands. An experienced dermatologist may also prescribe Robinul for compensatory hyperhidrosis as well.

William Ting, MD
Bay Area Dermatologic Surgeon
4.8 out of 5 stars 12 reviews

Will miraDry treat compensatory sweating after ETS?


Dear RSAgirl,

miraDry is currently indicated for treating excessive underarm sweating (ie. axillary hyperhidrosis) only. It is unknown whether miraDry is effective for compensatory sweating of the underarms and other areas of the body, as this has not been tested.

Warmest wishes,

Larry Fan, MD

Larry Fan, MD
San Francisco Plastic Surgeon
4.3 out of 5 stars 14 reviews

Comensatory sweating treatment with miraDry

You are in S Africa so doctors there are not FDA regulated and they should be able to do the procedure in areas outside of the underarms. I don't see any problems with that BUT I would not use it in the genitalia, butt crack, palms, feet - so, in my opinion it can be used in the lower back, inner thighs, back of the thighs safely - it is to the discretion of the treating doctor - in the US we have to wait for FDA approval unless we choose to do it 'off label' - good luck and update me on how well you do.

Hratch Karamanoukian, MD, FACS
Buffalo Phlebologist
4.8 out of 5 stars 41 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.