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American Family Physician Jun 2018Hyperhidrosis is excessive sweating that affects patients' quality of life, resulting in social and work impairment and emotional distress. Primary hyperhidrosis is... (Review)
Review
Hyperhidrosis is excessive sweating that affects patients' quality of life, resulting in social and work impairment and emotional distress. Primary hyperhidrosis is bilaterally symmetric, focal, excessive sweating of the axillae, palms, soles, or craniofacial region not caused by other underlying conditions. Secondary hyperhidrosis may be focal or generalized, and is caused by an underlying medical condition or medication use. The Hyperhidrosis Disease Severity Scale is a validated survey used to grade the tolerability of sweating and its impact on quality of life. The score can be used to guide treatment. Topical aluminum chloride solution is the initial treatment in most cases of primary focal hyperhidrosis. Topical glycopyrrolate is first-line treatment for craniofacial sweating. Botulinum toxin injection (onabotulinumtoxinA) is considered first- or second-line treatment for axillary, palmar, plantar, or craniofacial hyperhidrosis. Iontophoresis should be considered for treating hyperhidrosis of the palms and soles. Oral anticholinergics are useful adjuncts in severe cases of hyperhidrosis when other treatments fail. Local microwave therapy is a newer treatment option for axillary hyperhidrosis. Local surgery and endoscopic thoracic sympathectomy should be considered in severe cases of hyperhidrosis that have not responded to topical or medical therapies.
Topics: Botulinum Toxins, Type A; Cholinergic Antagonists; Humans; Hyperhidrosis; Patient Selection; Quality of Life; Sweating; Sympathectomy; Treatment Outcome
PubMed: 30215934
DOI: No ID Found -
Journal of Cosmetic Dermatology Jan 2022Axillary hyperhidrosis characterized by excessive sweating in the axillary regions is a frustrating chronic autonomic disorder leading to social embarrassment, impaired... (Review)
Review
BACKGROUND
Axillary hyperhidrosis characterized by excessive sweating in the axillary regions is a frustrating chronic autonomic disorder leading to social embarrassment, impaired quality of life and usually associated with palmoplantar hyperhidrosis. Identifying the condition and its cause is central to the management.
AIM
The aim of this article is to discuss treatment options for axillary hyperhidrosis.
METHODS
Comprehensive literature search using PubMed and Google Scholar was performed to review relevant published articles related to diagnosis and treatment of axillary hyperhidrosis.
RESULTS
Treatment modalities for axillary hyperhydrosis vary from topical and systemic agents to injectables, newer devices and surgical measures. None except for physical measures using devices or surgery, which destroys the sweat glands to remove them, is possibly permanent and most are associated with attendant side effects.
CONCLUSION
Several treatments including medical and surgical option are available for the treatment of axillary hyperhydrosis. Patient education is important component of its management. Individualized approach of management is necessary for optimal outcome of treatment.
Topics: Axilla; Humans; Hyperhidrosis; Quality of Life; Sweat Glands; Sweating; Treatment Outcome
PubMed: 34416078
DOI: 10.1111/jocd.14378 -
Actas Dermo-sifiliograficas Mar 2022Aquagenic keratoderma is an uncommon acquired dermatosis characterized by edema and whitish-translucent papules triggered by immersion or contact with water. Cases have... (Review)
Review
Aquagenic keratoderma is an uncommon acquired dermatosis characterized by edema and whitish-translucent papules triggered by immersion or contact with water. Cases have been described in association with certain medications, hyperhidrosis, and cystic fibrosis. The aim of this review is to evaluate the effectiveness of different treatments for aquagenic keratoderma. We reviewed the literature and analyzed treatments for aquagenic keratoderma described in case series and reports. Aquagenic keratoderma associated with hyperhidrosis can be treated effectively. Tap water iontophoresis, endoscopic thoracic sympathectomy, botulinum toxin injections, and oxybutynin are effective against refractory forms. Topical salicylic acid and aluminum salts are effective, but of little value as maintenance therapy. Oral oxybutynin 5 mg/d is probably the best option for treating aquagenic keratoderma. The reported pathophysiological effects of nonsteroidal anti inflammatory drugs in this setting suggest that the use of prostaglandins might be justified. Additional studies are needed to investigate these hypotheses and resolve other questions.
Topics: Anti-Inflammatory Agents, Non-Steroidal; Humans; Hyperhidrosis; Keratoderma, Palmoplantar; Salicylic Acid; Water
PubMed: 34126071
DOI: 10.1016/j.ad.2021.05.016 -
The American Journal of Managed Care Dec 2018Sweating plays a vital role for humans. However, excessive sweating, also called hyperhidrosis, is a condition resulting in sweating beyond what is physiologically... (Review)
Review
Sweating plays a vital role for humans. However, excessive sweating, also called hyperhidrosis, is a condition resulting in sweating beyond what is physiologically necessary. The increased rate of sweating is not caused by external stimuli or temperature fluctuations, as with an individual without hyperhidrosis. Hyperhidrosis affects approximately 4.8% of Americans. Primary hyperhidrosis, a specific classification of the disease, primarily affects younger adults aged 18 to 39 years, and it often has a genetic component. Living with hyperhidrosis presents many challenges and impacts numerous aspects of daily life. Patients with hyperhidrosis are impacted in their social and professional lifestyles, as well as their mental and emotional health. These negative effects, which have been studied, lead to a lower quality of life (QOL) in this population. Additionally, constant moisture from sweating can lead to skin maceration. This increases the risk of skin conditions such as athlete's foot and more severe conditions such as bacterial infections or pitted keratolysis. Study results report a nearly 30% greater risk of skin infections in patients with hyperhidrosis compared with healthy controls. This section of the continuing education supplement will examine the pathophysiology and clinical severity of hyperhidrosis and identify the comorbidities and QOL challenges associated with this condition.
Topics: Adolescent; Adult; Humans; Hyperhidrosis; Quality of Life; Severity of Illness Index
PubMed: 30589248
DOI: No ID Found -
Ugeskrift For Laeger Dec 2018
Topics: Axilla; Humans; Hyperhidrosis; Microwaves
PubMed: 30520716
DOI: No ID Found -
Skin Therapy Letter Mar 2019Hyperhidrosis is a condition characterized by excessive sweat production beyond which is physiologically necessary for thermal regulation. Affecting over 4.8% of the... (Review)
Review
Hyperhidrosis is a condition characterized by excessive sweat production beyond which is physiologically necessary for thermal regulation. Affecting over 4.8% of the United States population, studies have shown that severe primary hyperhidrosis interferes with daily activities and can be considered intolerable, negatively impacting a patient’s quality of life. Glycopyrronium tosylate is a topical anticholinergic agent that reduces sweat production by blocking the activation of acetylcholine receptors in peripheral sweat glands. In clinical trials, topical glycopyrronium tosylate, a pre-moistened cloth containing 2.4% glycopyrronium solution, was shown to be an effective, safe and non-invasive treatment for patients suffering from primary hyperhidrosis. This review examines the clinical trials of topical glycopyrronium tosylate and its role in primary hyperhidrosis. Glycopyrronium tosylate was recently US FDA-approved (as of June 2018) to manage patients with primary axillary hyperhidrosis.
Topics: Administration, Cutaneous; Cholinergic Antagonists; Clinical Trials as Topic; Glycopyrrolate; Humans; Hyperhidrosis
PubMed: 30970203
DOI: No ID Found -
Australian Family Physician May 2013Hyperhidrosis and bromhidrosis are two common conditions, which are troublesome for patients and carry a significant psychosocial burden. (Review)
Review
BACKGROUND
Hyperhidrosis and bromhidrosis are two common conditions, which are troublesome for patients and carry a significant psychosocial burden.
OBJECTIVE
This article details an approach to the assessment and management of hyperhidrosis and bromhidrosis, and outlines current treatment options.
DISCUSSION
Hyperhidrosis can be either generalised or focal. Generalised hyperhidrosis may be primary and idiopathic or secondary to systemic disease. Treatment may require oral anticholinergic agents. Focal hyperhidrosis is usually primary and responds to topical measures. Specialist referral for botulinum toxin A, iontophoresis or sympathectomy should be considered for severe cases. Bromhidrosis usually responds to antiperspirants, fragrance and antibacterial agents.
Topics: Disease Management; Humans; Hyperhidrosis; Practice Guidelines as Topic
PubMed: 23781522
DOI: No ID Found -
The Journal of Dermatological Treatment Dec 2023Hyperhidrosis can significantly curtail patient quality of life, from debilitating physical symptoms to social stigmatization and reduced life opportunities. Current...
Hyperhidrosis can significantly curtail patient quality of life, from debilitating physical symptoms to social stigmatization and reduced life opportunities. Current treatments often prove unsatisfactory, especially in sufferers of generalized hyperhidrosis. In this open trial, we present the case of a refractory generalized hyperhidrosis treated with cannabinoids. We found a remarkable reduction in the volume of sweat and an improvement to the patient's quality of life using this novel low-cost and low-impact approach.
Topics: Humans; Cannabinoids; Quality of Life; Hyperhidrosis; Sweating
PubMed: 36200741
DOI: 10.1080/09546634.2022.2127308 -
Medicine Jul 2023Hyperhidrosis (chronic excessive sweating) may substantially affect an individual's emotional and social well-being. Therapies available before onabotulinumtoxinA were... (Randomized Controlled Trial)
Randomized Controlled Trial
Hyperhidrosis (chronic excessive sweating) may substantially affect an individual's emotional and social well-being. Therapies available before onabotulinumtoxinA were generally topical, with limited effectiveness, application-site skin reactions, and frequent, time-consuming treatments. Intradermal injection of onabotulinumtoxinA to treat sweat glands arose as a novel therapeutic approach. To develop this treatment, appropriate dosing needed to be established, and training on administration was required. Further, no previous scale existed to measure the effects of hyperhidrosis on patients' lives, leading Allergan to develop and validate the 4-point Hyperhidrosis Disease Severity Scale (HDSS), which measures the disease's impact on daily activities. The onabotulinumtoxinA clinical development program for hyperhidrosis included 2 double-blind, placebo-controlled pivotal trials, immunogenicity studies, long-term studies of safety and efficacy, and quality of life assessments. In Europe and North America, the primary efficacy measures were, respectively, axillary sweat production measured gravimetrically and HDSS improvement. Compared with placebo, onabotulinumtoxinA treatment significantly reduced axillary sweat production and axillary hyperhidrosis severity, as measured by a 2-point or greater reduction on the HDSS. The effects of onabotulinumtoxinA occurred rapidly, within 1 week after injection, and lasted ≥6 months. Treatment with onabotulinumtoxinA was associated with significant quality of life improvements based on Short Form-12 physical and mental component scores. The Hyperhidrosis Impact Questionnaire also indicated greater treatment satisfaction, reduced negative impact on aspects of daily life, and improved emotional well-being with onabotulinumtoxinA versus placebo. The clinical development program and subsequent clinical experience showed that onabotulinumtoxinA treatment for hyperhidrosis was well tolerated with no new safety signals, and led to greater disease awareness.
Topics: Humans; Botulinum Toxins, Type A; Treatment Outcome; Quality of Life; Hyperhidrosis; Injections, Intradermal; Axilla; Double-Blind Method
PubMed: 37499084
DOI: 10.1097/MD.0000000000032764 -
Actas Dermo-sifiliograficas May 2015Until quite recently, clinical guidelines and reviews on the treatment of hyperhidrosis advised against the use of systemic therapies based on their unacceptable adverse... (Review)
Review
Until quite recently, clinical guidelines and reviews on the treatment of hyperhidrosis advised against the use of systemic therapies based on their unacceptable adverse effects and a lack of evidence of usefulness. Numerous studies published over the past few years, however, have shown that, when used appropriately, these treatments are effective and in general have a favorable tolerability profile, making them an additional option for the treatment of hyperhidrosis, particularly for disease that is widespread, multifocal, or resistant to other treatments. In this review, the first of its kind, we examine the systemic therapies available for hyperhidrosis, including antihypertensives, psychoactive agents, and in particular oral anticholinergics, although none of these drugs are currently approved for this indication.
Topics: Antihypertensive Agents; Cholinergic Antagonists; Clinical Trials as Topic; Disease Management; Evidence-Based Medicine; Glycopyrrolate; Humans; Hyperhidrosis; Meta-Analysis as Topic; Off-Label Use; Psychotropic Drugs
PubMed: 25638324
DOI: 10.1016/j.ad.2014.11.012