Current therapeutic strategies for hyperhidrosis: a review

Area of Science:

• Dermatology
• Medical Treatments

Background:

• Hyperhidrosis is the overproduction of sweat by exocrine glands, presenting in localized or generalized forms.
• Excessive sweating leads to significant psychosocial stress, impacting patients' private and professional lives.
• When not caused by an underlying treatable disease, hyperhidrosis requires symptomatic management.

Purpose of the Study:

• To review current and alternative treatment options for hyperhidrosis.
• To evaluate the efficacy and safety of various therapeutic modalities for localized and generalized sweating.

Main Methods:

• Review of conservative treatments including topical agents (aluminum chloride), botulinum toxin injections, and tap water iontophoresis.
• Discussion of surgical interventions such as curettage, liposuction, and sympathectomy.
• Consideration of systemic anticholinergic medications and their limitations.

Main Results:

• Topical aluminum chloride and botulinum toxin are effective for axillary hyperhidrosis, with surgery reserved for refractory cases.
• Tap water iontophoresis, potentially enhanced with anticholinergic substances, is the primary treatment for palmoplantar hyperhidrosis.
• Systemic anticholinergic medications offer limited utility due to adverse effects.

Conclusions:

• Established treatments like tap water iontophoresis and aluminum chloride remain valuable for hyperhidrosis management.
• Botulinum toxin presents a promising alternative with sustained efficacy.
• Surgical options, particularly sympathectomy, are reserved for severe, well-justified cases due to invasiveness.