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Background: Thermotherapy has been established between conservative and surgical options as a minimally invasive method for the treatment of axillary hyperhidrosis., Objective: The objective of this study was to present radiofrequency thermotherapy (RFTT) as a safe and effective new treatment method., Materials and Methods: Thirty adult patients with pronounced axillary hyperhidrosis were treated with RFTT with noninsulated microneedles 3 times at intervals of 6 weeks. Subjective improvement was rated using the Hyperhidrosis Disease Severity Scale (HDSS) and Dermatology Life Quality Index (DLQI). Satisfaction and estimated reduction of sweating were monitored. Objective measurements were made using gravimetry. Adverse effects were recorded in follow-up. At the 6-month follow-up, improvement in sweating was seen in 27 patients. The HDSS dropped from 3.4 to 2.1, the DLQI improved significantly from 16 to 7. The gravimetric measurements of sweat were reduced from 221 to 33 mg/min. The average reduction of sweating was reported to be 72%. Adverse effects were generally mild and improved rapidly., Conclusion: Radiofrequency thermotherapy was shown to be an effective and minimally invasive treatment option for axillary hyperhidrosis. Patients described their sweating as normal. The method clearly has the potential to normalize axillary sweating. more...

Background: There is a wide variation in the reported prevalence of primary hyperhidrosis in the literature. Further, it is unknown if primary hyperhidrosis is a lifelong condition, or if demographical factors influence hyperhidrosis prevalence., Objectives: This study aims to examine the prevalence of hyperhidrosis in multiple ethnic groups from two ethnically diverse cities and to determine if the prevalence of primary hyperhidrosis changes according to age, gender, ethnicity, body mass index, and geographical locations., Methods: In total, 1010 consecutive subjects attending dermatology outpatient clinics in Shanghai Skin Disease Hospital and 1018 subjects in Skin Care Center of Vancouver General Hospital were invited to fill out a questionnaire on their presenting concerns, demographical information, and sweating symptoms. The subjects were then classified to have primary hyperhidrosis using the criteria of International Hyperhidrosis Society, late-onset hyperhidrosis, or no-hyperhidrosis. The prevalence of primary HH and late-onset HH was calculated for the entire study population and in subgroups stratified according to age of examination, sex, ethnicity, presenting diagnosis, body mass index, and specific study cities. Multivariate logistic regression analyses were performed to assess the impact of these factors on HH prevalence., Results: The prevalence of primary hyperhidrosis is very similar in Shanghai and in Vancouver, at 14.5% and 12.3% respectively. In addition, 4.0% of subjects in Shanghai and 4.4% subjects in Vancouver suffer from late-onset HH. Primary HH has highest prevalence in those younger than 30 years of age, decreasing dramatically in later years. Caucasian subjects are at least 2.5 times more likely to develop axillary hyperhidrosis compared to Chinese subjects. Obesity does not have much influence on primary HH presentation, although it does increase significantly the development of late-onset HH. Finally, there is no major difference of hyperhidrosis between Chinese subjects in Shanghai and Vancouver., Limitations: The data were gathered according to patients' self-reports only and the sample size was relatively small in some groups after stratification for gender, ethnicity and age., Conclusion: Prevalence of primary HH and late-onset HH is similar in dermatology outpatients independent of geographical locations. However, certain specific HH subtypes can show great variations according to ethnicity, age, body mass index and sex. more...

Hyperhidrosis affects 2.8% of the population and has severe negative influence on life quality. The disease is represented in many specialties but can unfortunately be incorrectly treated or not treated at all. Primary hyperhidrosis is the most common form. Secondary hyperhidrosis is most often excluded by a few anamnestic data. Botulinum toxin and anticholinergics are adequate treatment options when aluminium chloride is insufficient. This article describes the disease from the physician's as well as the patient's perspective. Furthermore, examination procedures and treatment procedures are presented. more...

In ethnic skin, traditional skin resurfacing procedures such as dermabrasion, chemical peels, and laser therapy can be effective but can also be associated with prolonged recovery and risk of complications. These complications can include a higher risk of dyspigmentation and scarring, and unsatisfactory clinical outcomes. Microneedling is an evolving treatment technique for an expanding number of dermatologic conditions. Microneedling may offer a more advantageous safety profile, particularly in the skin-of-color population (Fitzpatrick skin types IV-VI), compared with more conventional resurfacing modalities. Thus far, it has been shown to be effective for a number of dermatologic conditions in this population, including scarring, melasma, melanosis, skin rejuvenation, acne vulgaris, and primary hyperhidrosis. This article aims to provide a comprehensive review of the literature regarding the efficacy and safety of microneedling in skin of color., (Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.) more...

Primary focal hyperhidrosis is a disease of unknown cause with profuse perspiration of local sites (head, face, palms, soles of feet, and axillae) that adversely affects daily life. Guidelines have been proposed in the USA [1], Canada [2], and Japan [3]. The symptoms impair quality of life, with significant negative effects on daily existence and personal relationships. The current goal in medical practice for patients with hyperhidrosis is to provide guidance and encourage coping skills for a normal daily life, as well as give appropriate advice regarding treatment options. On occasion, in order to improve quality of life, it is necessary to recommend surgical therapy when conservative treatment fails; this requires an understanding of the mechanisms of available treatments and their effects. This paper reviews theories of primary focal hyperhidrosis with regard to pathology, epidemiology, and treatment., (© 2016 S. Karger AG, Basel.) more...

Hyperhidrosis can be localized or generalized and may cause the patient significant discomfort. Localized hyperhidrosis is usually primary, often begins in adolescence and is partly based on genetic dispositions. As a rule it does not necessitate investigations for secondary causes (e.g. endocrine or neurologic conditions). Generalized hyperhidrosis is commonly associated with environmental or lifestyle factors, and sometimes physiological factors. In new-onset generalized sweating of unclear origin, it may be appropriate to consider secondary causes (underlying diseases, medications, infections). Relatively effective symptomatic treatments are available in localized hyperhidrosis. The treatment of generalized hyperhidrosis is almost always directed against the underlying factors. more...

This article reviewed some of the more common diseases of the skin appendages that are encountered in medicine: hyperhidrosis, acne, AA, FPHL, AGA, and TE. The pathophysiology behind the conditions and their treatments were discussed so that the clinician can make logical therapeutic choices for their affected patients., (Copyright © 2015 Elsevier Inc. All rights reserved.) more...

Background: Primary craniofacial hyperhidrosis (CH) can have a profoundly negative impact on quality of life. No comprehensive review of its management exists., Objective: The objective of this review is to present the best clinical evidence to guide CH management., Methods: A systematic review was performed using PRISMA guidelines. MEDLINE and EMBASE were searched from 1966 to 2014 for articles using the MeSH terms "Hyperhidrosis", "Head", "Neck" and synonymous text words. Inclusion criteria were experimental and observational studies addressing CH treatment. Two reviewers independently assessed study quality and analysed data., Results: Of 833 references yielded, 27 met inclusion criteria and were analysed. Twenty-two studies evaluated T2 sympathetic ablation (Level III evidence). Outcome measures were subjective and mean follow-up was 29 months. Reported efficacy was high (70-100%), recurrence rates were generally low (0-8%) and complications largely transient (e.g. pneumothorax 0-1%). However, 8-95.4% experienced troubling compensatory sweating. One randomised controlled trial and one observational study evaluated botulinum toxin A (Level Ib and III, respectively). Both employed objective outcome measures and demonstrated similar findings. Efficacy was 100%, lasted a median of 5-6 months and frontalis muscle inhibition was the main adverse effect (50-100%). Three studies evaluated anticholinergic therapy: topical glycopyrrolate demonstrated high efficacy (96%) with minimal adverse effects (Level Ib) and oral oxybutynin demonstrated relatively high efficacy (80-100%) but with noticeable adverse effects (76.6-83.6%) (Level III)., Conclusion: There are few quality studies evaluating CH treatment. Based on available evidence, we recommend topical glycopyrrolate, oral oxybutynin and intradermal botulinum toxin A as first-line therapies due to their efficacy and safety. T2 sympathectomy should be considered for patients refractory to first-line therapy. more...

Background: The purpose of this review is to summarize the extent of the problem of axillary hyperhidrosis and treatment modalities available. The benefits and disadvantages of various treatments are reflected on with the hope of providing a starting point to investigate new ways of treating hyperhidrosis., Material & Methods: A literature search was conducted using various databases and search criteria., Results: Current treatments include aluminium chloride antiperspirants, iontophoresis, botox injections and endoscopic thoracic sympathectomy. Botox therapy is usually the most effective treatment, without surgery or unpleasant side effects. However it has to be administered by a skilled clinician and involves around 20 injections to treat axillary hyperhidrosis. Other ways of giving Botox are being developed, the most promising one being the use of microneedles which are able to penetrate the skin and deliver drugs to the target area of the dermis without causing pain. In comparison to the temporary effects of microneedles, laser and microwave therapies are also assessed as they offer the hope of permanent relief from hyperhidrosis., Conclusion: There is a considerable dearth in the literature on the management of axillary hyperhidrosis. Further study in larger populations with longer follow up times is critical to access the long term effects of treatment. Microneedles could be the future treatment of choice with the potential to deliver drugs in a safe and pain free way., (Copyright © 2015 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.) more...

Hyperhidrosis continues to be undertreated in our view, despite its propensity to considerably impair quality of life. We shall break down therapeutic approaches to hyperhidrosis into several steps: (a) determine the physiological causes of excess sweating; (b) establish the type of hyperhidrosis involved and screen for causes of secondary hyperhidrosis before diagnosing essential hyperhidrosis; (c) evaluate the severity of the hyperhidrosis by means of a validated scale (HDSS score), Minor's starch-iodine test or gravimetric analysis; (d) select one of the medical therapies currently available, i.e. topical therapy (antiperspirants, iontophoresis or botulinum toxin injection), systemic therapy (oxybutynin) or surgery (thoracic sympathectomy)., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.) more...

Introduction: Hyperhidrosis is a debilitating problem that is not only uncomfortable and inconvenient, but also embarrassing in work and social situations. In spite of the availability of several options for the treatment of axillary hyperhidrosis, recently, there has been an increasing interest in the use of laser therapy. This study aims to evaluate the efficacy of a laser diode device emitting at wavelengths of 924 and 975 nm and classical curettage either alone, simultaneously or in combination., Material and Methods: A randomized prospective controlled trial was carried out on 100 patients divided into four groups, each with a different protocol: Laser alone at 975 nm (group 1), laser alone at 924/975 nm simultaneously (group 2), curettage alone (group 3), and finally laser at 924/975 nm followed by curettage (group 4). HDSS, starch test and GAIS were used to assess treatment efficacy. The follow-up extended to one year. Statistical analysis (SPSS) was used to determine the accuracy of the results., Result: Two patients of group 1 experienced burns during treatment, which took over a month to heal. This group of patients achieved the worst results: The starch test scale results after treatment were 2.48 ± 0.51 and 2.76 ± 0.44 (at 1 and 12 months). The GAIS results were 1.04 ± 0.35 and 0.92 ± 0.28 (1 and 12 months). In group 2 the starch test scale results after treatment were 1.36 ± 0.49 and 1.48 ± 0.51 (at 1 and 12 months). The GAIS results were 2.36 ± 0.49 and 2.72 ± 0.46 (at 1 and 12 months). In group 3, the starch test scale results after treatment were 1.56 ± 0.51 and 1.76 ± 0.60 (at 1 and 12 months), which corresponds to small to substantially smaller dark areas. The GAIS results were 2.28 ± 0.46 and 2.64 ± 0.49 (at 1 and 12 months). The best results were obtained in group 4: HDSS scores were reduced from 3.88 ± 0.33 before treatment to 1.24 ± 0.44 and 0.48 ± 0.51 at the 1 and 12 months controls. The starch test scale results after treatment were 0.40 ± 0.50 and 0.44 ± 0.51 (at 1 and 12 months). The GAIS results were 3.72 ± 0.54 and 3.76 ± 0.44 (at 1 and 12 months)., Conclusion: In this study, the laser at 924/975 nm combined with curettage was determined to be the optimal treatment option of those tested for axillary hyperhidrosis. This treatment was safe, with few side effects and improvement that persisted to one year follow-up., (© 2015 Wiley Periodicals, Inc.) more...

To assess the incidence and severity of self-reported hyperhidrosis in patients with amputation and understand its effects on prosthetic fit or function, a cross-sectional survey of patients at two amputee clinics was performed. Responses from 121 subjects with lower-limb amputation were analyzed. Of these subjects, 66% reported sweating to a degree that it interfered with daily activities, as measured by the Hyperhidrosis Disease Severity Scale. There was a significant association between sweating and interference with prosthetic fit and function. Sweating was more severe in cases of transtibial amputations, patients under the age of 60, warm weather, and vigorous activity. There was no relationship between severity of sweating and time since amputation, etiology of amputation, duration of daily prosthetic use, or reported ability to perform functional tasks. Subjects reported trying multiple interventions, but the self-reported effectiveness of these treatments was low. Hyperhidrosis, a common problem associated with prosthetic usage, varies in severity and often interferes with daily activities. Sweating severity is associated with poor prosthetic fit and function. Risk factors include younger age and transtibial amputation status. Treatment strategies generally lack efficacy. The results of this study may provide guidance for future interventions and treatment options. more...

Objectives: Primary hyperhidrosis is an under-recognized condition in children and adolescents. Iontophoresis is the second line of treatment for palmoplantar hyperhidrosis following topical treatment. The studies evaluating the efficacy of iontophoresis in children are limited. We aimed to investigate the efficacy and reliability of tap water iontophoresis in children with primary hyperhidrosis., Methods: Twenty-one patients aged under 18 years, who received iontophoresis for primary palmoplantar hyperhidrosis, were included in the study. In our clinic, tap water iontophoresis was administered at regular intervals, starting with five times per week and decreased to once a week on fifth week. Then maintenance sessions once a week for 6 weeks are recommended. The presence of excessive sweating was scored by visual analogue scale (VAS): "0" as continuation of excessive sweating and "10" as the absence of excessive sweating. The demographic and clinical data were collected from files. Also, patients fulfilled a questionnaire for efficacy on follow-up visit., Results: Nineteen patients completed the whole 21 sessions. The mean VAS score was 5.89 ± 1.49 at the end of the 15th session and 6.36 ± 2.06 at the end of the treatment. Side effects were well tolerated. Only seven patients were still free of excessive sweating on third months after treatment. The mean satisfaction score was 4.95 ± 2.38, as measured by VAS where 0 indicated dissatisfaction and 10 indicated high satisfaction., Conclusion: Tap water iontophoresis is an effective method of treatment for primary palmoplantar and axillary hyperhidrosis in paediatric patients. But there are still unanswered questions about the mechanism of action, ideal session intervals and protocols for maximum efficacy. more...

To analyze the efficacy of different surgical methods in treating palmar hyperhidrosis and the compensatory hyperhidrosis after surgery and to observe the efficacy of "Energy-boosting and Yin-nourishing anti-perspirant formula" on postsurgical hyperhidrosis patients. Two-hundred patients were randomly assigned to groups A (Chinese and Western medicine, T4 transection plus "Energy-boosting and Yin-nourishing anti-perspirant formula") and B (Western medicine, T4 transection). The surgical efficiency, recurrence rate, compensatory hyperhidrosis, and the long-term life quality were compared. Another 100 cases (group C, T2 transection) were analyzed as a control group. After surgery, the palmar hyperhidrosis and armpit sweating were relieved in all the three group patients and in 34 % of patients combined with plantar hyperhidrosis, the symptoms were relieved. Transient palmar hyperhidrosis was found in three cases at day 2 to day 5 postoperatively. One case of Horner's syndrome and one case recurrence were found in group C patients. The compensatory sweating of various degrees occurred in all the three groups. There were 25, 24, and 43 cases in groups A, B, and C, respectively. There is a significant difference between groups C, A, and B. The compensatory sweating in 13 cases of group A and four cases of group B had different degrees of improvement in the follow-up 6 months after surgery. There is a significant difference. Thoracoscopic bilateral T4 sympathetic chain and the Kuntz resection are the optimized surgical treatments for the palmar hyperhidrosis. "Energy-boosting and Yin-nourishing anti-perspirant formula" is effective in treating the postoperative compensatory sweating. more...

Hyperhidrosis is a reason for treatment by many specialists in medicine, such as dermatologists, family medicine doctors, surgeons and also psychiatrists. Hyperhidrosis causes considerable distress and disability. Despite the fact that the condition has been known for thousands of years, it is yet unclear whether excessive sweating derives from emotional" activation of the central nervous system, whether the emotional symptoms evolve due to local dysfunction of the sweat glands, or a combination of the two problems. In this article, we will present two conditions: hyperhidrosis and Social Anxiety Disorder, a mental condition with anxiety and avoidanrce in social settings that is frequently accompanied by sweating. We will discuss the similarities and differences between these disorders and the various treatments available for these conditions. Research shows that social anxiety does not explain hyperhidrosis, but that excessive sweating reduces the threshold for social anxiety. Among people with hyperhidrosis, the functional disability and the emotional problems are mediated by the social anxiety. We propose treating the symptoms of hyperhidrosis and social anxiety disorder in combination in order to achieve maximal improvement in these patients. more...

The excessive sweating of hyperhidrosis creates profound psychosocial, professional, and financial burdens on the individual sufferer; it contributes to impaired self-worth and self-efficacy, decreased satisfaction in all relationships, avoidance of specific careers, and increased expenditures on everything from clothing to medical treatment. Despite morbidity equal to other well-known dermatologic conditions, hyperhidrosis has historically been underacknowledged and undertreated because of the lack of accessible, scientifically accurate information and dispersal of that information within patient and medical communities. Thankfully, the development of the Internet and the work of the not-for-profit International Hyperhidrosis Society (IHHS) have increased awareness of hyperhidrosis., (Copyright © 2014 Elsevier Inc. All rights reserved.) more...

Proper billing and coding are essential to document the diagnosis of hyperhidrosis and to assure proper reimbursement for treatment. Providers should become familiar with the payment policies of local health plans to streamline the preauthorization process that is often needed for many treatments commonly used for hyperhidrosis. Having a preprinted letter of medical necessity and patient intake forms that record the necessary historical information about the disease, previous treatments, and other pertinent information will help increase the speed of the office flow. This article presents algorithms for treatment of the various forms of primary focal hyperhidrosis., (Copyright © 2014 Elsevier Inc. All rights reserved.) more...

Iontophoresis is a safe, efficacious, and cost-effective primary treatment of palmar and plantar hyperhidrosis. Decades of clinical experience and research show significant reduction in palmoplantar excessive sweating with minimal side effects. To get the best results from iontophoresis, health care professionals need to provide education on the mechanism of action and benefits, evidence of its use, and creation of a future patient-specific plan of care for continued treatments at home or in the physician's office. Iontophoresis may be combined with other hyperhidrosis treatments, such as topical antiperspirants and botulinum toxin injections., (Copyright © 2014 Elsevier Inc. All rights reserved.) more...

New therapies are being investigated to treat hyperhidrosis. Novel methods of delivering botulinum toxins and new topical therapies have been developed. Devices that can deliver heat to the area of the eccrine units can reduce sweating. Further studies need to be performed., (Copyright © 2014 Elsevier Inc. All rights reserved.) more...

Hyperhidrosis, characterized by excess sweat production, affects children and adults. Primary focal hyperhidrosis affects any anatomic region with sweat appendages present. Primary hyperhidrosis has traditionally been considered a problem for adults, but approximately 1.6% of adolescents and 0.6% of prepubertal children are affected. Psychological and social development and well-being are often affected, leading to profound emotional and social distress. Quality of life can be improved by early diagnosis and therapy; however, underdiagnosis and lack of knowledge regarding therapeutic options has hindered optimization of therapy in the pediatric population. This article reviews the treatment options for hyperhidrosis with a focus on the pediatric population., (Copyright © 2014 Elsevier Inc. All rights reserved.) more...

Purpose of Review: Primary focal hyperhidrosis is a common condition that negatively impacts quality of life for many pediatric patients and can be challenging to treat. Standard treatments for hyperhidrosis can be used with success in many patients, and newer therapies and techniques offer options that have demonstrated efficacy and safety. This review highlights standard therapies for primary focal hyperhidrosis as well as the most recent technique advancements and alternative treatment options., Recent Findings: The standard approach to treating primary focal hyperhidrosis remains initiation of topical preparations, followed by advancement to systemic medications, local administration of medication and/or surgical procedures. Recent studies focus on enhancing tolerability of topical preparations as well as evaluating the efficacy of neuromodulator injections, oral anticholinergic medications and laser therapy. Microwave technology has also been introduced for the treatment of focal hyperhidrosis with promising results., Summary: Many therapies exist for hyperhidrosis, and each treatment plan must be evaluated on a patient-by-patient basis. Advances in standard therapies and emergence of new treatment techniques are the main emphases of current published literature on hyperhidrosis. This article presents recent therapeutic options as well as updates on more established strategies to help practitioners treat this challenging condition. more...

Background: Patients tend to be noncompliant with tap water iontophoresis (TWI), which is an effective treatment option for palmoplantar hyperhidrosis., Objective: To investigate compliance with TWI in patients with palmoplantar hyperhidrosis and identify the factors limiting its utility., Methods: The medical data of 22 patients treated with TWI for palmoplantar hyperhidrosis were collected. A telephone inquiry questioning overall satisfaction with the treatment and the reasons for discontinuation was conducted., Results: Sixteen patients completed the initial treatment period, and all responded well to the therapy. Eight patients started on the maintenance treatment, five of whom gave up before completing five sessions. The reasons for discontinuation were a lack of time in 12 patients, switching to home therapy in 3 patients, and side effects in 1 patient., Conclusion: Patients with palmoplantar hyperhidrosis are noncompliant with TWI, mainly due to a lack of time. They should be well informed before therapy and be encouraged to have a home device for maintenance. more...

Objective: Evaluation of pain and degree of satisfaction in patients undergoing ultrasound-assisted peripheral regional block for the treatment of idiopathic palmar hyperhidrosis with botulinum toxin., Patients and Methods: A descriptive, observational study of patients with palmar hyperhidrosis treated with botulinum toxin A, who underwent ultrasound-guided peripheral regional block of the median and ulnar nerves with 3 ml of mepivacaine 1% in each one. The radial nerve block was injected in the anatomical snuffbox. After establishing blocking, the dermatologist performed a mapping and injected around 100 IU of botulinum toxin across the whole palm. The pain experienced during the injection of botulinum toxin was evaluated by verbal numerical scale (from 0 to 10), along with the degree of satisfaction with the anesthetic technique, and the post-anesthetic complications., Results: A total of 40 patients were enrolled in the study, 11 men and 29 women with no significant differences. The pain intensity assessed with verbal numerical scale was 1.03 (standard deviation of 1.37). No patients had a value greater than 5. The degree of patient satisfaction with the anesthetic technique was very good for 85% of the patients, and good for 7.5%. There were no complications related to type of anesthesia., Conclusions: The ultrasound-assisted peripheral regional block could be a simple, effective and safe technique for patients undergoing palmar injection of botulinum toxin. Pain intensity was very low, and it provided a very good level of satisfaction in most patients., (Copyright © 2013 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.) more...

Primary hyperhidrosis is a disorder of excessive, bilateral and relatively symmetrical sweating occurring in the palms, soles and axillae regions without obvious etiology. There have been some reports of the epidemiology of primary hyperhidrosis abroad so far, but there has never been any research performed in Japan. We performed a questionnaire survey for people aged 5-64 years who agreed with the purpose of this study at 20 companies or schools, and received 5807 valid responses. From this survey, each prevalence could broken down into 5.33% for primary palm hyperhidrosis, 2.79% for primary plantar hyperhidrosis, 5.75% for primary axillae hyperhidrosis and 4.7% for primary head hyperhidrosis. Patients with severe symptoms were estimated to be approximately 616,000 for primary palmar hyperhidrosis and 2,239,000 for primary axillae hyperhidrosis in Japan. These findings reveal that many patients feel a decreased quality of life because of symptoms of hyperhidrosis every day. However, only 6.2% of the patients had visited medical institutions. Moreover, few patients take appropriate treatment even after visiting the hospital., (© 2013 Japanese Dermatological Association.) more...

Hyperhidrosis is a common and under-recognized disease in the pediatric population that has a significant impact on quality of life. Focal and generalized forms of hyperhidrosis exist, which can be idiopathic or secondary to underlying medical conditions or medications. Treatment is tailored to the specific patient needs, characteristics and goals. These include topical preparations, iontophoresis, botulinum toxin and anticholinergic medications., (© 2013 Wiley Periodicals, Inc.) more...

Three cases of primary hyperhidrosis of no known cause, with excess sweating day and night, were treated using the same acupuncture points. The patients reported that their sweating decreased and that they felt better after the treatment. more...

Background: Hyperhidrosis and bromhidrosis are two common conditions, which are troublesome for patients and carry a significant psychosocial burden., Objective: This article details an approach to the assessment and management of hyperhidrosis and bromhidrosis, and outlines current treatment options., Discussion: Hyperhidrosis can be either generalised or focal. Generalised hyperhidrosis may be primary and idiopathic or secondary to systemic disease. Treatment may require oral anticholinergic agents. Focal hyperhidrosis is usually primary and responds to topical measures. Specialist referral for botulinum toxin A, iontophoresis or sympathectomy should be considered for severe cases. Bromhidrosis usually responds to antiperspirants, fragrance and antibacterial agents. more...

Background: Palmar hyperhidrosis is characterized by excessive sweating on the palm. Although botulinum toxin is effective and safe treatment for palmar hyperhidrosis, some patients require inexpensive, easy-to-use therapeutic modalities., Objective: To evaluate the efficacy and safety of a portable "dry-type" iontophoretic device for treatment of palmar hyperhidrosis., Participants: Twenty-three volunteers with idiopathic palmar hyperhidrosis were enrolled; 20 completed the study., Methods: Participants were instructed to grasp the device with the left palm for 20 minutes once a day for 4 weeks. Follow-up evaluation was conducted during 4 weeks after termination of the treatment session. Sweat intensity, Investigator Global Assessment (IGA), patient satisfaction assessment (PSA), and hydration capacitance were measured for evaluation of efficacy. Adverse effects were investigated for evaluation of safety., Results: Statistically significantly greater improvement in IGA and hydration capacitance was achieved in the treated palm than in the untreated palm. Improvement in sweat intensity and PSA was not statistically significantly different in the treated and untreated palms. Two cases of mild local adverse effects were noted., Conclusion: The device is an effective therapeutic modality for palmar hyperhidrosis in addition to local injection of botulinum toxin, endoscopic sympathectomy, and conventional iontophoretic treatments., (© 2013 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.) more...

Primary focal hyperhidrosis is a benign condition of unknown etiology. Tap water iontophoresis has long been known to inhibit sweat production. The mechanism of reduced hyperhidrosis by iontophoresis is not completely clear. For operational convenience, our patients received their treatments at different intervals to those recommended by the manufacturer of the iontophoresis unit. We performed a retrospective audit to evaluate the effectiveness of tap water iontophoresis using this regimen. This new treatment regimen was effective at controlling palmoplantar hyperhidrosis. Minimal undesirable effects such as mild skin irritation and erythema were noted but none were severe enough to necessitate discontinuation of treatment. In conclusion, tap water iontophoresis is a safe and effective treatment of palmar and plantar hyperhidrosis when used on Monday, Wednesday, and Friday for 4 weeks. Continued treatment is needed to maintain the effect and many patients go on to purchase their own machines. This technique should be considered prior to systemic or aggressive surgical intervention. more...