Axillary Hyperhidrosis and Bromhidrosis: The Dermatologist’s Point of View
Primary focal hyperhidrosis of the axillae (axillary hyperhidrosis) is a prevalent condition that affects quality of life. It has a genetic component and usually occurs during puberty and worsens with stress, exercise, and high external temperature. Classically, the dermatological treatments are topical (antiperspirants with aluminum chloride and glycopyrrolate 2%), injectable (botulinum toxin), or systemic (oral anticholinergics, β-blockers, benzodiazepines, and clonidine). Recently, new drugs and technologies have emerged for the treatment of axillary hyperhidrosis, such as oxybutynin gel, botulinum toxin for transdermal application, microwave energy thermolysis, radiofrequency applied with micro-needles, lasers, and microfocused ultrasound. These treatments are discussed in detail in this chapter. Bromhidrosis is a condition more common in men after puberty and is caused by the increased secretion of the sweat glands associated with local bacterial proliferation. The treatment includes local hygiene, antiseptic soap, antiperspirant, and topical antibiotics. In addition, epilation and reduction of local sweat can be performed.