Hyperhidrosis: Clinical presentation, evaluation and management

Abstract

Hyperhidrosis (HH) is defined as excessive sweating, which can affect any part of the body. Current data suggests that it affects 2-3% of the population. For many patients it is debilitating and impairs social interactions. Current management of patients diagnosed with focal HH depends on the etiology and location of the excessive sweating. For primary focal HH, nonsurgical approaches include topical agents such as aluminum chloride hexahydrate, oral agents such as anticholinergics, iontophoresis, botulinum toxin injections and psychotherapy. With careful patient selection, surgery has been shown to be extremely effective for the management of patients diagnosed with palmar and axillary HH. Surgery has evolved to be performed using videoscopic techniques either by clipping or cutting the sympathetic chain with or without resection of the ganglia. Preliminary studies suggest that surgery may also play an effective role in the management of craniofacial and plantar HH. © 2010 Expert Reviews Ltd.