Hyperhidrosis: Evolving therapies for a well-established phenomenon

John H. Eisenach, John L.D. Atkinson, Robert D. Fealey

Research output: Contribution to journalReview article

137 Scopus citations

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 sweat response regulated by the preoptic-anterior hypothalamus. Diagnosis of these mechanistically ambiguous disorders is primarily from patient history and physical examination, whereas results of laboratory studies performed with indicator powder 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 antiperspirants or anticholinergics. Iontophoresis is available for palmar-plantar and axillary hyperhidrosis. Botulinum 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.

Original languageEnglish (US)
Pages (from-to)657-666
Number of pages10
JournalMayo Clinic proceedings
Volume80
Issue number5
DOIs
StatePublished - May 2005

ASJC Scopus subject areas

  • Medicine(all)

Fingerprint Dive into the research topics of 'Hyperhidrosis: Evolving therapies for a well-established phenomenon'. Together they form a unique fingerprint.

  • Cite this