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Topical botulinum toxin A can be delivered through intact skin.
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Topical anticholinergic agents may provide efficacy with decreased adverse effects.
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Devices delivering energy such as lasers, ultrasound, and radiofrequency may reduce focal sweat.
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Limited data are available, and more research is needed.
Managing Hyperhidrosis: Emerging Therapies
Section snippets
Key points
Summary
There is still a need for new therapies for the treatment of primary and secondary forms of hyperhidrosis. Understanding the location of the sweat glands and the pharmacology of sweat will help to drive new developments.
References (17)
- et al.
Ulthera: initial and six month results
Facial Plast Surg Clin North Am
(2012) Treatment of hyperhidrosis with microwave technology
Semin Cutan Med Surg
(2013)- et al.
A randomized, blinded clinical evaluation of a novel microwave device for treating axillary hyperhidrosis: the dermatologic reduction in underarm perspiration study
Dermatol Surg
(2012) Topically applied botulinum toxin type A for the treatment of primary axillary hyperhidrosis: results of a randomized, blinded, vehicle-controlled study
Dermatol Surg
(2007)- et al.
Topical glycopyrrolate for axillary hyperhidrosis
Br J Dermatol
(2013) - et al.
Craniofacial hyperhidrosis successfully treated with topical glycopyrrolate
South Med J
(2002) - et al.
Therapeutic hotline: topical glycopyrrolate: a successful treatment for craniofacial hyperhidrosis and eccrine hidrocystomas
Dermatol Ther
(2010) - et al.
A randomised controlled trial of topical glycopyrrolate, the first specific treatment for diabetic gustatory sweating
Diabetologia
(1997)
Cited by (12)
The etiology, diagnosis, and management of hyperhidrosis: A comprehensive review: Therapeutic options
2019, Journal of the American Academy of DermatologyCitation Excerpt :Topical glycopyrrolate (0.5% to 4% solution, gel, cream, or pads) and 3% topical oxybutynin are the most commonly used topical anticholinergic agents.36,37 Adverse effects include skin irritation, pruritus, headache, dizziness, sore throat, mydriasis, dry mouth, constipation, and nasopharyngitis.34,36,38-41 BTX is a common effective injectable medication for HH, but its large molecular size prevents it from crossing intact skin.42
Percutaneous CT–Guided Sympathicolysis with Radiofrequency for the Treatment of Palmar Hyperhidrosis
2017, Journal of Vascular and Interventional RadiologyPreliminary Experience with Transdermal Oxybutynin Patches for Hyperhidrosis
2016, Actas Dermo-SifiliograficasThe efficacy of oral anticholinergics for sympathetic overactivity in a thoracic surgery clinic
2016, Journal of Thoracic and Cardiovascular SurgeryCitation Excerpt :Most notably, botulinum toxin has proved an effective albeit temporary and costly therapy. Many ingenious local device therapies also have been tested, including fractional radiofrequency, iontophoresis, lasers, and ultrasound but have established mixed results.6 The most limiting aspects of topical and localized therapies are their transient efficacy and the challenge to treating multifocal disease.
Computed Tomography-Guided Percutaneous T4 Thoracic Sympathetic Radiofrequency Thermocoagulation for Primary Palmar Hyperhidrosis: A Retrospective Observational Trial
2023, CardioVascular and Interventional RadiologyTreatment of Axillary hyperhidrosis
2022, Journal of Cosmetic Dermatology
Disclosure: D.A. Glaser has served as advisor for Allergan, Galderma, Miramar Labs, and Unilever. She has been an investigator and received research grants from Allergan, Miramar Labs, and Ulthera. T.A. Galperin has nothing to disclose.