Hyperhidrosis: Systemic Treatment (For Professionnals)

Systemic therapy for primary hyperhidrosis: a retrospective study of 59 patients treated with glycopyrrolate or clonidine.

Walling HW.

J Am Acad Dermatol. 2012 Mar;66(3):387-92. Epub 2011 Aug 4.

• Hyperhidrosis is a socially bothersome and psychologically devastating condition which occurs spontaneously, but can reach extreme proportions in hot and humid wethaer conditions.
• Treatment options appear to be limited and include topical aluminium chloride srystals, botulinium toxin injections and in extreme cases surgical sympathectomy.
• This retropsective study from the USA explores systemic therapy with the three treatments:

1. Glycopyrrolate (generally 1-2 mg once or twice daily) (45 patients) with response rate of 67% (after at least 2 months of treatment). Fifteen treatment failures included 6 nonresponders and 9 with adverse effects, including xerostomia and gastrointestinal disturbance.
2. Clonidine (0.1 mg twice daily) (13 patients) with a response rate of 46% (after at least 2 months of treatment) . Seven treatment failures included 3 nonresponders and 4 with adverse effects, all relating to decreased blood pressure.
3. Oxybutyrin 5mg twice daily

• In the study concerning 71 patients, 17% were lost to follow up. There were no differences in efficacy between glycopyrrolate and clonidine

Source of Information: 2012 (09) – Thiers B. 21st Annual Congress of the EADV (European Academy of Dermatology and Venerology) – Prague (Praha), Czech Republic (česká republika)