Hyperhidrosis
What Is Hyperhidrosis?
Hyperhidrosis refers to a state of sweating so heavily that it interferes with daily life. When heavy sweating is caused by a drug side effect or as a symptom of a nervous-system or endocrine disorder, it is called secondary hyperhidrosis; when no cause can be identified, it is called primary hyperhidrosis. Below, we explain primary hyperhidrosis.
When sweating occurs all over the body it is called generalized hyperhidrosis, and when it is confined to one part of the body, localized (focal) hyperhidrosis; symptoms in the armpits and palms are especially common. Even though sweating is “heavy,” it is hard to measure the amount, and the way you sweat changes during the day depending on activity and environment, so it helps with diagnosis if you tell us about specific problems, such as being embarrassed by sweat stains under the arms of your shirt even in winter, or not being able to hold documents because your hands are wet even indoors at work.
It is a troublesome condition, but insurance-covered treatments, such as topical medications and injectable drugs, have been increasing.
Generalized Hyperhidrosis
Generalized hyperhidrosis is a condition in which the whole body sweats heavily, beyond the amount needed for temperature regulation. The causes vary and are broadly divided into the following two types.
Secondary generalized hyperhidrosis
A state of abnormal sweating all over the body due to some illness or the effect of a medication.
| Main underlying diseases | Hyperthyroidism, diabetes, menopausal disorder, Parkinson’s disease, tuberculosis, sepsis, etc. |
|---|---|
| Main causative drugs | Antidepressants, anti-anxiety drugs, sleeping pills, steroids, etc. |
Primary generalized hyperhidrosis
Diagnosed when no causative illness or medication can be found. It is relatively common in younger people and a family history is sometimes seen. A characteristic feature is that the person does not sweat during sleep.
Localized (Focal) Hyperhidrosis
Localized hyperhidrosis is a condition in which heavy sweating occurs in specific parts of the body, such as the palms, soles, armpits, and face. The causes are mainly divided into the following two types.
Secondary localized hyperhidrosis
Abnormal sweating in just one part of the body, caused by peripheral nerve damage or a skin disease.
If the amount of sweat differs between the left and right sides of the body, a hidden nervous-system disease is possible, so caution is needed. “Gustatory hyperhidrosis,” in which the face sweats when eating spicy food, is also a type of this.
Primary localized hyperhidrosis
Primary localized hyperhidrosis is a condition in which heavy sweating occurs in specific areas such as the palms, soles, and armpits, mainly caused by mental tension and stress.
Hyperhidrosis is basically diagnosed by examination alone, but when sweating occurs all over the body, we may check with blood tests and the like to be sure no other illness is hidden.
Our Clinic’s Approach to Treatment
For those troubled by hyperhidrosis, our clinic offers treatments tailored to each patient’s symptoms and lifestyle, such as injections and topical medications. Please do not suffer alone; feel free to consult us first.
Treatments for Hyperhidrosis
Here we explain the treatment of hyperhidrosis.
Apohide® Lotion
“Apohide® Lotion 20%” is a medication for primary palmar hyperhidrosis. Its active ingredient, oxybutynin hydrochloride, acts on the muscarinic receptors in the eccrine sweat glands to suppress sweating.
| Eligible age | 12 years and older |
|---|---|
| Application site | Palms |
| How to use | Apply to the palms once a day before bed |
| Efficacy | In clinical trials, more than half of patients had at least a 50% improvement in sweat volume four weeks after starting treatment. In addition, the proportion of patients with at least a 50% improvement in sweat volume at four weeks was significantly higher in the treatment group (52.8%) than in the placebo group (24.3%). |
| Contraindications | Glaucoma, benign prostatic hyperplasia, heart disease, intestinal obstruction, etc. |
| Side effects | Dry skin, itching, erythema, dermatitis, dry mouth, compensatory sweating, etc. |
Ecclock® Gel
“Ecclock® Gel 5%” is a topical medication for primary axillary hyperhidrosis, that is, underarm sweat. Its active ingredient, sofpironium bromide, acts on the muscarinic receptors in the eccrine sweat glands to suppress sweating.
| Eligible age | 12 years and older |
|---|---|
| Application site | Armpits |
| How to use | Apply to both armpits once a day |
| Efficacy | In clinical trials, more than half of patients had at least a 50% improvement in sweat volume four weeks after starting treatment. Furthermore, at six weeks, the proportion achieving both a “sweating score of 1 or 2” and “at least a 50% improvement in sweat volume” was 53.9% in the treatment group versus 36.4% in the placebo group. |
| Contraindications | Glaucoma, benign prostatic hyperplasia, etc. |
| Side effects | Dermatitis, erythema, itching, eczema, dry mouth, dilated pupils, blurred vision, compensatory sweating, etc. |
Rapifort® Wipes
“Rapifort® Wipes 2.5%” is a medication for primary axillary hyperhidrosis, that is, underarm sweat. As a single-use sheet preparation, it is easy to use and hygienic.
Its active ingredient, glycopyrronium tosylate hydrate, acts on the muscarinic receptors in the eccrine sweat glands to suppress sweating.
| Eligible age | 9 years and older |
|---|---|
| Application site | Armpits |
| How to use | Apply to both armpits once a day |
| Efficacy | In clinical trials, the proportion with at least a 50% improvement in average sweat weight reached 92.9% by the second week. In clinical trials, at four weeks the proportion of patients with at least a two-level improvement in sweating score and at least a 50% improvement in sweat volume was significantly higher in the treatment group (41.1%) than in the placebo group (16.4%). |
| Contraindications | Glaucoma, benign prostatic hyperplasia, etc. |
| Side effects | Disturbance of eye accommodation (dilated pupils, light sensitivity, blurred vision, dry eye), dry mouth, difficulty urinating, frequent urination, eczema, etc. Dry eye, dry mouth, anhidrosis (absence of sweating), etc. |
Botulinum Toxin Injection (partly self-pay)
Botulinum toxin injection is well known for its use in cosmetic medicine to smooth wrinkles, but it is also used to treat hyperhidrosis. Injecting type A botulinum toxin blocks nerve transmission from the sympathetic nerves to the sweat glands, reducing the amount of sweat. GlaxoSmithKline’s botulinum toxin is covered by insurance only for severe axillary hyperhidrosis. In addition, our clinic also offers Allergan’s botulinum toxin as a self-pay treatment.
Learn more about botulinum toxin injection
| Application site | Armpits, palms, soles Axilla (armpit) |
|---|---|
| Efficacy | Effects usually appear in two to three days, and sweat volume is reduced for about four to nine months. |
| Contraindications | Those who are pregnant or breastfeeding, or who have had an allergic reaction to botulinum toxin, cannot receive it. |
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Micro-injection Therapy (self-pay)
Micro-injection therapy is a treatment in which botulinum toxin is injected in small amounts into the superficial layers of the skin. It is used for hyperhidrosis of the face, especially the forehead, and reduces sweating by suppressing the action of the neurotransmitter (acetylcholine) that signals sweating. It can also be expected to suppress sebum secretion and improve pores.
Learn more about botulinum toxin injection
| Application site | Forehead, face |
|---|---|
| Efficacy | Effects usually appear in two to fourteen days and last about three to six months. |
| Contraindications | Those who are pregnant or breastfeeding, or who have had an allergic reaction to botulinum toxin, cannot receive it. |
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