Variety of therapeutic approaches to primary hyperhidrosis (HH) and botulinum toxin priority over other treatment options in this condition - a review
DOI:
https://doi.org/10.12775/QS.2024.25.54770Keywords
hyperhidrosis, primary hyperhidrosis, botulinum toxin, treatment, quality of life, iontophoresis, sympathectomyAbstract
Introduction and purpose
Hyperhidrosis (HH) is a medical conditions that affects more and more people every year. It is characterized by undue sweating without any temperature changes and significantly above the body’s thermoregulation needs. Primary hyperhidrosis is associated with genetic and psychological factors, as the etiology is not yet found. Treatment is aimed at the symptoms. Secondary
hyperhidrosis happens as an adverse event of drugs taken by patient or is a part of neurological, endocrine or oncological diseases. Teratment should be focused on the main underlying disease. The quality of life of these patients is reduced and it affects their psychological health.
This study inevstigates currently available methods of treatment.
State of knowledge
Various treatment options for hyperhidrosis range from topical aluminum salts for mild cases to oral anti-cholinergic agents for more severe conditions. Additional methods include iontophoresis, lasers like Nd:Yag, and botulinum toxin injections, known for their effectiveness. Surgical procedures such as Endoscopic Thoracic Sympathectomy, local skin excision, liposuction-curettage are also available for severe cases. Consultation with a healthcare provider is crucial to determine the most suitable treatment based on individual needs and preferences.
Conclusions
Literature provides valuable insights into hyperhidrosis and its treatments, emphasizing the importance of patient expectations and safety. Starting with topical aluminum salts for mild cases, treatments need to be reapplied regularly. Surgical options are considered if conservative treatments fail, but they come with potential risks. Botulinum toxin injections stand out for their efficacy, quick procedure, and the convenience of one or two annual sessions, making them a popular choice in many aesthetic clinics. Consulting with healthcare professionals is key to selecting the most suitable treatment approach for individual needs.
References
Brackenrich J, Fagg Ch. Hyperhidrosis. 2022 Oct 3. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–.
Schlereth T, Dieterich M, Birklein F. Hyperhidrosis - Causes and Treatment of Enhanced Sweating. Dtsch Arztebl Int. 2009 Jan; 106(3): 32–37.. doi: 10.3238/arztebl.2009.0032
Lakraj A-AD, Moghimi N, Jabb B. Hyperhidrosis: Anatomy, Pathophysiology and Treatment
with Emphasis on the Role of Botulinum Toxins. Toxins (Basel). 2013 Apr; 5(4): 821–840. https://doi.org/10.3390/toxins5040821
Parveen A, Abbas S, Mehmood N, Patafi M, Wajid U, Luqman M et al. Primary hyperhidrosis: from a genetics point of view. Journal of Family Medicine and Primary Care 12(12):p 3028-3032, December 2023.
Thomas I, Brown J, Vafaie J, Schwartz RA. Palmoplantar hyperhidrosis: a therapeutic challenge. Am Fam Physician. 2004 Mar 1;69(5):1117-20.
Solish N, Bertucci V, Dansereau A, Hong HC, Lynde C, Lupin M, Smith KC, Storwick G; Canadian Hyperhidrosis Advisory Committee. A comprehensive approach to the recognition, diagnosis, and severity-based treatment of focal hyperhidrosis: recommendations of the Canadian Hyperhidrosis Advisory Committee. Dermatol Surg. 2007 Aug;33(8):908-23. doi: 10.1111/ j.1524-4725.2007.33192.x.
.Stashak A, Brewer J. Management of hyperhidrosis. Clin Cosmet Investig Dermatol. 2014;7:285-299 https://doi.org/10.2147/CCID.S53119
Nyamekye IK. Current Therapeutic Options For Treating Primary Hyperhidrosis. Eur J Vasc Endovasc Surg 27, 571–576 (2004). doi: 10.1016/j.ejvs.2004.01.023
Grabell DA, Hebert AA. Current and Emerging Medical Therapies for Primary Hyperhidrosis. Dermatol Ther (Heidelb). 2017 Mar;7(1):25-36. doi: 10.1007/s13555-016-0148-z.
McConaghy JR, Fosselman D. Hyperhidrosis: Management Options. Am Fam Physician. 2018 Jun 1;97(11):729-734.
Rajagopal R, Mallya NB. Comparative evaluation of botulinum toxin versus iontophoresis with topical aluminium chloride hexahydrate in treatment of palmar hyperhidrosis. Med J Armed Forces India. 2014 Jul;70(3):247-52. doi: 10.1016/j.mjafi.2014.01.008.
Goldman A, Wollina U. Subdermal Nd-YAG laser for axillary hyperhidrosis. Dermatol Surg. 2008;34(6):756–762
Hong HC, Lupin M, O'Shaughnessy KF. Clinical evaluation of a microwave device for treating axillary hyperhidrosis. Dermatol Surg. 2012 May;38(5):728-35. doi: 10.1111/ j.1524-4725.2012.02375.x.
Wolosker N, Teivelis MP, Krutman M, de Paula RP, Kauffman P, de Campos JR et al. Long- term results of the use of oxybutynin for the treatment of axillary hyperhidrosis. Ann Vasc Surg. 2014 Jul;28(5):1106-12. doi: 10.1016/j.avsg.2013.12.024.
Collin J, Whatling P. Treating hyperhidrosis. Surgery and botulinum toxin are treatments of choice in severe cases. BMJ. 2000 May 6;320(7244):1221-2. doi: 10.1136/bmj.320.7244.1221
Kuijpers M, Klinkenberg TJ, Bouma W, DeJongste MJ, Mariani MA. Single-port one-stage bilateral thoracoscopic sympathicotomy for severe hyperhidrosis: prospective analysis of a standardized approach. J Cardiothorac Surg. 8, 216 (2013). https://doi.org/ 10.1186/1749-8090-8-216
Bell D, Jedynak J, Bell R. Predictors of outcome following endoscopic thoracic sympathectomy. ANZ Journal of Surgery. 2014 Jan-Feb;84(1-2):68-72. doi: 10.1111/ans.12098.
Atkinson JLD, Fode-Thomas NC, Fealey RD, Eisenach JH, Goerss SJ. Endoscopic Transthoracic Limited Sympathotomy for Palmar-Plantar Hyperhidrosis: Outcomes and Complications During a 10-Year Period. Mayo Clinic Proceedings. 2011 Aug; 86(8): 721–729.
doi: 10.4065/mcp.2011.0199
Tronstad Ch, Heising P, Tønseth KA, Grimnes S, Krogstad AL. Tumescent suction curettage vs. curettage only for treatment of axillary hyperhidrosis evaluated by subjective and new objective methods. Acta Derm Venereol. 2014 Mar;94(2):215-20. doi: 10.2340/00015555-1671.
Satriyasa BK. Botulinum toxin (Botox) A for reducing the appearance of facial wrinkles: a literature review of clinical use and pharmacological aspect. Clin Cosmet Investig Dermatol. 2019 Apr 10;12:223-228. doi: 10.2147/CCID.S202919.
Marani A, Gioacchini H, Paolinelli, Bobyr I, Martina E, Radi G, Diotalallevi F, Campanati A. Pain control during the Treatment of Primary Palmar Hyperhidrosis with Botulinum Toxin A by a Topical Application of Liposomal Lidocaine: Clinical Effectiveness. Toxins (Basel). 2024 Jan; 16(1): 28.
Campanati A, Diotallevi F, Radi G, Martina E, Marconi B, Bobyr I et al. Efficacy and Safety of Botulinum Toxin B in Focal Hyperhidrosis: A Narrative Review. Toxins (Basel). 2023 Feb 11;15(2):147. doi: 10.3390/toxins15020147.
Kouris A, Armyra K, Christodoulou Ch, Karimali P, Karypidis D, Kontochristopoulos G. Quality of Life in Patients with Focal Hyperhidrosis Before and after Treatment with Botulinum Toxin A. ISRN Dermatol. 2014; 2014: 308650 doi: 10.1155/2014/308650
Moffat CE, Hayes WG, Nyamekye IK. Durability of botulinum toxin treatment for axillary hyperhidrosis. Eur J Vasc Endovasc Surg. 2009 Aug;38(2):188-91. doi: 10.1016/j.ejvs.2009.03.016. doi: 10.1097/MD.0000000000032764
Naumann M, Lowe NJ. Botulinum toxin type A in treatment of bilateral primary axillary hyperhidrosis: randomised, parallel group, double blind, placebo controlled trial. BMJ. 2001 Sep 15; 323(7313): 596. doi: 10.1136/bmj.323.7313.596
Ibrahim O, Kakar R, Bolotin D, Nodzenski M, Disphanurat W, Pace N et al. The comparative
effectiveness of suction-curettage and onabotulinumtoxin-A injections for the treatment of primary focal axillary hyperhidrosis: randomized control trial. J Am Acad Dermatol. 2013 Jul;69(1):88-95. doi: 10.1016/j.jaad.2013.02.013.
Castiglione L, Murariu M, Boeriu E, Enatescu I, Cauli O. Assesing Botulinum Toxin Effectiveness and Quality of Life in Axillary Hyperhidrosis: A One-Year Prospective Study. Diseases. 2024 Jan; 12(1): 15. doi: 10.3390/diseases12010015
Glaser DA, Pariser DM, Hebert AA, Landells I, Somogyi Ch, Weng E, Brin MF, Beddingfield F. A Prospective, Nonrandomized, Open-Label Study of the Efficacy and Safety of OnabotulinumtoxinA in Adolescents with primary Axillary Hyperhidrosis. Pediatr Dermatol. 2015 Sep-Oct;32(5):609-17. doi: 10.1111/pde.12620.
Scamoni S, Valdatta L, Frigo C, Francesca Maggiulli, Cherubino M. Treatment of primary axillary hyperhidrosis with botulinum toxin type a: our experience in 50 patients from 2007 to 2010. ISRN Dermatol. 2012:2012:702714. doi: 10.5402/2012/702714.
Lowe N, Naumann M, Eadie N. Treatment of hyperhidrosis with Botox (onabotulinumtoxinA): Development, insights and impact. Medicine(Baltimore). 2023 Jul 1; 102(Suppl ): e32764.
Wee SY, Park ES. Immunogenicity of botulinum toxin. Arch Plast Surg. 2022 Jan; 49(1): 12–18 doi: 10.5999/aps.2021.00766
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Igor Pawlak, Klaudia Perkowska, Anna Kaźmierczak, Wiktoria Izdebska, Patrycja Sornek, Agata Borkowska, Anna Kiełb, Anna Mich, Radosław Ciesielski, Jakub Stanek
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 213
Number of citations: 0
