TITLE

Hyperhidrosis: Evolving Therapies for a Well-Established Phenomenon

AUTHOR(S)
Eisenach, John H.; Atkinson, John L. D.; Fealey, Robert D.
PUB. DATE
May 2005
SOURCE
Mayo Clinic Proceedings;May2005, Vol. 80 Issue 5, p657
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
The socially embarrassing disorder of excessive sweating, or hyperhidrosis, and its treatment options are gaining widespread attention. In order of frequency, palmar-plantar, palmar-axillary, isolated axillary, and craniofacial hyperhidrosis are distinct disorders of sudomotor regulation. A common link among these disorders is an excessive, nonthermoregulatory sweat response often to emotional stimuli in body regions influenced by the anterior cingulate cortex as opposed to the thermoregulatory sweets response regulated by the preoptic-anterior hypothalamus. Diagnosis of these mechanistically amblguous disorders is primarily from patient history and physical examination, whereas results of laboratory studies performed with indicator power reveal the distribution and severity of resting hyperhidrosis and document the integrity of thermoregulatory sweating. Treatment options lie on a continuum based on the severity of hyperhidrosis and the risks and benefits of therapy. In general, therapy begins with antipersplrants or anticholinergics. Iontophoresis is available for palmariantar and axillary hyperhidrosis. Botullnum toxin type A or local excision/curettage is effective for isolated axillary hyperhidrosis not responsive to topical application of aluminum chloride. Endoscopic thoracic sympathectomy may be used for severe cases of palmar-plantar and palmar-axillary hyperhidrosis. No sole therapy of choice has emerged for craniofacial sweating. The long-term sequelae of hyperhidrosis and its treatment also are discussed.
ACCESSION #
17019257

 

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