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American Journal of Clinical Dermatology

Published in:

01-10-2003 | Review Article

Management of Primary Hyperhidrosis

A Summary of the Different Treatment Modalities

Authors: Dr Maureen Connolly, David de Berker

Published in: American Journal of Clinical Dermatology | Issue 10/2003

Abstract

Hyperhidrosis is a common and distressing condition involving increased production of sweat. A variety of treatment modalities are used to try to control or reduce sweating. Sweat is secreted by eccrine glands innervated by cholinergic fibers from the sympathetic nervous system. Primary hyperhidrosis most commonly affects palms, axillae and soles. Secondary hyperhidrosis is caused by an underlying condition, and treatment involves the removal or control of this condition.

The treatment options for primary hyperhidrosis involve a range of topical or systemic medications, psychotherapy and surgical or non-surgical invasive techniques. Topical antiperspirants are quick and easy to apply but they can cause skin irritation and have a short half life. Systemic medications, in particular anticholinergics, reduce sweating but the dose required to control sweating can cause significant adverse effects, thus, limiting the medications’ effectiveness. Iontophoresis is a simple and well tolerated method for the treatment of hyperhidrosis without long-term adverse effects; however, long-term maintenance treatments are required to keep patients symptom free. Botulinum toxin A has emerged as a treatment for hyperhidrosis over the past 5–6 years with studies showing good results. Unfortunately, botulinum toxin A is not a permanent solution, and patients require repeat injections every 6–8 months to maintain benefits. Psychotherapy has been beneficial in a small number of cases. Percutaneous computed tomography-guided phenol sympathicolysis achieved good results but has a high long-term failure rate. Surgery has also been shown to successfully reduce hyperhidrosis but, like other therapies, has several complications and patients need to be informed of these prior to undergoing surgery. The excision of axillary sweat glands can cause unsightly scarring and transthoracic sympathectomy (either open or endoscopic) can be associated with complications of compensatory and gustatory hyperhidrosis, Horner syndrome and neuralgia, some of which patients may find worse than the condition itself.

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Title: Management of Primary Hyperhidrosis
A Summary of the Different Treatment Modalities
Authors: Dr Maureen Connolly
David de Berker
Publication date: 01-10-2003
Publisher: Springer International Publishing
Published in: American Journal of Clinical Dermatology / Issue 10/2003
Print ISSN: 1175-0561
Electronic ISSN: 1179-1888
DOI: https://doi.org/10.2165/00128071-200304100-00003

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Management of Primary Hyperhidrosis

A Summary of the Different Treatment Modalities

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Keynote webinar | Spotlight on medication adherence

Springer Medicine

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