Diagnosis and management of hyperhidrosis

  title={Diagnosis and management of hyperhidrosis},
  author={Ruth A Benson and Rachel Palin and Peter E. Holt and Ian M. Loftus},
  journal={BMJ : British Medical Journal},
#### Summary points Primary hyperhidrosis is characterised by sweating in excess of that needed for normal thermoregulation.1 The condition often goes unreported because of embarrassment,2 and management is hindered by a poor evidence base and lack of clinical guidelines. Anxiety about social situations and relationships, and problems with daily living, such as an inability to hold a pen at work, can affect quality of life.3 Hyperhidrosis may be associated with bromhidrosis (unpleasant odour… 
Interventions for hyperhidrosis in secondary care: a systematic review and value-of-information analysis.
The effectiveness review indicated that iontophoresis, BTX, medication, curettage and ETS was the most cost-effective sequence, with an incremental cost-effectiveness ratio of £9304 per quality-adjusted life-year, and the Hyperhidrosis Quality of Life Index was superior to other tools commonly used in hyperhidrosis research for assessing quality of life.
Examining hyperhidrosis: an update on new treatments.
  • C. Jacob
  • Medicine, Psychology
    The American journal of managed care
  • 2018
New treatment modalities, surgical procedures, associated comorbidities, and the impact on managed care of hyperhidrosis are discussed, so clinicians can tailor therapy, improve outcomes, and increase patient satisfaction.
Psychological and Psychiatric Management of Patients with Hyperhidrosis
So far, cause and consequence of sweating, stress, and psychopathological symptoms are still unclear due to their reciprocal interaction.
Shelley procedure in axillary hyperhidrosis
This study assessed change in QoL of patients with AHH following SP, which involves day-case removal under local anaesthetic of the dermal eccrine sweat glands through a central axillary incision and the impact of AHH on patients’ quality of life (QoL) in the preceding week.
Retrospective analysis of the efficacy and duration of botulinum toxin A injections in 30 patients with palmar hyperhidrosis
There was evidence for a median reduction in the Hyperhidrosis Disease Severity Scale, a qualitative self‐reported score, as well as an increasing duration of efficacy with repeated injections, which suggests that treatment of palmar hyperhidrosis should be considered earlier and more frequently.
Multicentre consensus recommendations for skin care in inherited epidermolysis bullosa
The aim of the present study has been to generate multicentre, multidisciplinary recommendations on global skin care addressed to physicians, nurses and other health professionals dealing with EB, both in centres of expertise and primary care setting.
Pain and quality of life evaluation in patients with localized epidermolysis bullosa simplex
EBS-l patients have frequent and severe pain with neuropathic characteristics, which is undertreated and affects quality of life (QoL).
Is still hyperhidrosis a worthy of investigation issue?—primary hyperhidrosis and its treatment: state of the art
Hyperhidrosis is an excessive sweating compared to physiological body thermoregulation that severely affects individual’s social, mental and working life leading to a lower QoL.
Elevated Social Stress Levels and Depressive Symptoms in Primary Hyperhidrosis
This initial study provides an impetus for further investigation to reveal a causative relationship between hyperhidrotics and its psychological concomitant to reveal the etiology of depression.
Oxybutynin for the Treatment of Primary Hyperhidrosis: Current State of the Art
Oxybutynin is an anticholinergic drug with an emerging role in the treatment of hyperhidrosis and shows universally good response among different groups of patients regardless of age, gender, and weight.


Palmar hyperhidrosis: evidence of genetic transmission.
It is concluded that primary palmar hyperhidrosis is a hereditary disorder, with variable penetrance and no proof of sex-linked transmission, and may lead to earlier diagnoses and advances in medical and psychosocial interventions.
Hyperhidrosis: evolving concepts and a comprehensive review.
Patient's estimation of efficacy of various hyperhidrosis treatments in a dermatological clinic.
The characteristics of sweating in patients referred for hyperhidrosis and their quality of life were investigated, using the Dermatology Life Quality Index and the Hyperhidrosis Disease Severity Scale and their estimation of efficacy of the treatments given, using a patient's global assessment score and thequality of life scores.
An epidemiological study of hyperhidrosis.
A descriptive, multicenter study of patterns of patients referred for treatment of focal hyperhidrosis, demonstrating novel findings, especially in the differing presentations ofhyperhidrosis between men and women.
Primary focal hyperhidrosis: current treatment options and a step‐by‐step approach
  • I. Hoorens, K. Ongenae
  • Medicine
    Journal of the European Academy of Dermatology and Venereology : JEADV
  • 2012
The challenge for the dermatologist remains to evaluate the severity of hyperhidrosis to achieve the best therapeutic outcome, this can be done most effectively using the Hyperhidrosis Disease Severity Scale (HDSS).
Hyperhidrosis: Anatomy, Pathophysiology and Treatment with Emphasis on the Role of Botulinum Toxins
Clinical features, anatomy and physiology of hyperhidrosis are presented with a review of the world literature on treatment and studies on BoNT-A iontophoresis are emerging; however, data on duration and frequency of application is inconsistent.
Hyperhidrosis--causes and treatment of enhanced sweating.
A step-by-step approach is recommended for the treatment of hyperhidrosis, which affects the axillae, hands, feet, and face--areas principally involved in emotional sweating.