Sports Medicine : Excessive Perspiration

Benefits of Transdermal Therapy | Benefits of Transdermal NSAIDs | Topical Anesthetics | Iontophoresis & Phonophoresis | Pregame Rubs | Hemorrhoids | Excessive Perspiration | Transdermal | Examples of Compounded Medications

Hyperhidrosis therapy

Excessive perspiration is a concern for many athletes, as well as members of dance teams and marching bands. Numerous topical treatment options exist.

Primary hyperhidrosis (excessive perspiration) is a physically and emotionally distressing condition which involves mainly the palms, soles, and axillae. Oral anticholinergic agents and beta-blockers may be effective for controlling or reducing profuse sweating, but also carry significant side effects. Topical therapies may be the most practical and most common treatment for hyperhidrosis, but many agents that have proven useful in clinical trials are not commercially available.

Placebo-controlled trials have shown that topically applied 20% aluminum chloride hexahydrate significantly reduces the symptoms of hyperhidrosis in 60%-100% of patients. Skin irritation can be minimized with 1% hydrocortisone cream or by compounding 20% aluminum chloride in a 4% salicylic acid gel base, instead of in anhydrous alcohol base (as is the commercial product Drysol®).

Luh and Blackwell of the Dept. of Internal Medicine, University of Texas Medical Branch at Galveston describe a healthy, active 27-year-old male resident physician who had excessive facial sweating with minimal exertion or stress. The sweating was especially pronounced on the forehead, nose, and upper lip. Daily topical application of a 0.5% glycopyrrolate solution to the face and forehead significantly reduced facial sweating after the first treatment, without any discomfort to the skin. No loss of efficacy was seen after multiple face washings. Facial hyperhidrosis recurred after withdrawal of the glycopyrrolate for 2 days, confirming its therapeutic effect. Two years later, he continues to use glycopyrrolate as needed.

Mayo Clin Proc 1986 Dec;61(12):951-6
Treatment of primary hyperhidrosis.
Click here to access the PubMed abstract of this article.

South Med J 2002 Jul;95(7):756-8
Craniofacial hyperhidrosis successfully treated with topical glycopyrrolate.
Click here to access the PubMed abstract of this article.

Ann Pharmacother 1995 May;29(5):489-92
Propantheline bromide in the management of hyperhidrosis associated with spinal cord injury.
Click here to access the PubMed abstract of this article.

Intl J Pharm Comp 2001 Jan/Feb;5(1):28-9
Glycopyrrolate 1% Cream
Click here to access the abstract of this article.

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