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Don’t Sweat It: Hyperhidrosis Treatment

In this exclusive MedPage Today video, Marisa K. Garshick, MD, of NewYork-Presbyterian/Weill Cornell Medical Center, describes hyperhidrosis as a condition that has a major impact on patients, and offers some pearls on treatment.

The following is a transcript of her remarks:

Hyperhidrosis does affect about 5% of the population worldwide, and that actually ends up including up to 15.3 million people in the U.S. alone. Knowing that this is a condition that can be physically uncomfortable, we’re now starting to better appreciate the impact it can have on people’s social lives, daily lives, as well as the emotional and psychological impact.

One recent study showed that those patients who have hyperhidrosis do tend to have a greater prevalence of anxiety and depression, as well as attention deficit disorder, when compared to the general public. Interestingly, this was not necessarily associated with the location of the hyperhidrosis or the severity. What this tells physicians and providers is that we really should be more aware in being able to recognize the impact that this can have for our patients.

Fortunately for the patients, we do have treatments that are available over-the-counter, so including antiperspirants such as Certain Dri, which actually do have ingredients that are essentially prescription-strength compounds, that can be available to the patients where they can get it over-the-counter.

Interestingly, many people don’t realize, but the best way to apply an antiperspirant is actually at nighttime. This is because that’s when the sweat glands are at rest, and it allows the sweat glands to be appropriately plugged and allows the antiperspirant to give the most benefit. That’s always a little pearl that’s helpful for us to recognize when patients come to us after having tried something and not knowing whether or not it’s working for them.

Certainly, for hyperhidrosis, we have lots of other treatments available. We do have prescription-strength antiperspirants. We have oral pills. There was a recent medication, FDA-approved in about July 2018 that was available in the U.S. in October, which was a topical anticholinergic called glycopyrronium tosylate, and basically this is a once-daily wipe that essentially has been shown to reduce sweating as early as within 1 week for patients.

Additionally, we have other treatments available. FDA-approved Botox has been shown to be effective for the treatment of axillary hyperhidrosis; also available are surgical modalities and then another device that uses electromagnetic energy to provide essentially heat destruction to the sweat glands. We feel fortunate in the world of hyperhidrosis that there is a lot of research happening as well as lots of treatment modalities available to our patients.