Skip to main content

Hyperhidrosis

  • Chapter
  • First Online:
Dermatology in Public Health Environments

Abstract

Hyperhidrosis is defined as sweating amounts larger than necessary to maintain normal body thermoregulation. This condition can affect the patient’s quality of life by way of its psychological and social impact. The central nervous system (cortex, hypothalamus, medulla) and sweat glands, including the eccrine, apocrine, and apoeccrine, are involved in the physiopathology of this condition. Hyperhidrosis can be divided into primary and secondary, and is also associated with a wide variety of conditions. Treatments to alleviate this disorder include topical products (aluminum compounds), iontophoresis, oral treatment with anticholinergic agents (glycopyrrolate, clonidine, oxybutynin), and interventional procedures such as botulinum toxin A, sweat gland removal (suction or curettage), lasers, microwave-based treatment, microfocused ultrasound, and sympathectomy. Understanding the clinical features of this disorder and treatment modalities is vital to the optimization of treatment for affected patients.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 229.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Free shipping worldwide - see info
Hardcover Book
USD 299.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

Abbreviations

AH:

Axillary hyperhidrosis

ASG:

Apocrine sweat glands

BoNT:

Botulinum neurotoxin

ETS:

Endoscopic thoracic sympathectomy

HH:

Hyperhidrosis

HIV:

Human immunodeficiency virus

NdYAG:

Neodymium yttrium aluminum garnet

NSAIDs:

Non-steroidal anti-inflammatory drugs

POEMS:

Polyneuropathy, organomegaly, endocrinopathy, M protein, skin changes

SSRIs:

Selective serotonin reuptake inhibitors

VIP:

Vasoactive intestinal peptide

References

  1. Leung AK, Chan PYH, Choi MCK. Hyperhidrosis. Int J Dermatol. 1999;38:5617.

    Google Scholar 

  2. Walling HW. Primary hyperhidrosis increases the risk of cutaneous infection: a case control study of 387 patients. J Am Acad Dermatol. 2009;61(2):242–6.

    Google Scholar 

  3. Lasek RJ, Chren MM. Acne vulgaris and the quality of life of adult dermatology patients. Arch Dermatol. 1998;134:454–8.

    Article  CAS  PubMed  Google Scholar 

  4. Higaki Y, Kawamoto K, Kamo T, Horikawa N, Kawashima M, Chren MM. The Japanese version of Skindex-16: a brief quality-of-life measure for patients with skin diseases. J Dermatol. 2002;29:693–8.

    Article  PubMed  Google Scholar 

  5. Walling HW. Clinical differentiation of primary from secondary hyperhidrosis. J Am Acad Dermatol. 2011;64(4):690–5.

    Article  PubMed  Google Scholar 

  6. Strutton DR, Kowalski JW, Glaser DA, Stang PE. US prevalence of hyperhidrosis and impact on individuals with axillary hyperhidrosis: results from a national survey. J Am Acad Dermatol. 2004;51:241–8.

    Article  PubMed  Google Scholar 

  7. Fujimoto T, Kawahara K, Yokozeki H. Epidemiological study and considerations of primary focal hyperhidrosis in Japan: from questionnaire analysis. J Dermatol. 2013;40:886–90.

    Article  PubMed  Google Scholar 

  8. Augustin M, Radtke MA, Herberger K, Kornek T, Heigel H, Schaefer I. Prevalence and disease burden of hyperhidrosis in the adult population. Dermatology. 2013;227:10–3.

    Article  CAS  PubMed  Google Scholar 

  9. Stefaniak T, Tomaszewski KA, Proczko-Markuszewska M, Idestal A, Royton A, Abi-Khalil C. Is subjective hyperhidrosis assessment sufficient enough? Prevalence of hyperhidrosis among young Polish adults. J Dermatol. 2013;40:819–23.

    PubMed  Google Scholar 

  10. Lear W, Kessler E, Solish N, Glaser DA. An epidemiological study of hyperhidrosis. Dermatol Surg. 2007;33:S69–75.

    Article  CAS  PubMed  Google Scholar 

  11. Ro KM, Cantor RM, Lange KL, Ahn SS. Palmar hyperhidrosis: evidence of genetic transmission. J Vasc Surg. 2002;35(2):382–6.

    Article  PubMed  Google Scholar 

  12. Quinton PM, Elder HY, Jenkinson DME, et al. Structure and function of human sweat glands. In: Laden K, editor. Antiperspirants and deodorants. New York: Marcel Dekker; 1999. p. 17–57.

    Google Scholar 

  13. Bovell DL, Clunes MT, Elder HY, Milsom J, Jenkinson DM. Ultrastructure of the hyperhidrotic eccrine gland. Br J Dermatol. 2001;145:298–301.

    Article  CAS  PubMed  Google Scholar 

  14. Dobson RL. The human eccrine gland. Arch Environ Health. 1965;2:423–9.

    Article  Google Scholar 

  15. Sato K, Kang WH, Saga K, Sato KT. Biology of sweat glands and their disorders. I. Normal sweat glands function. J Am Acad Dermatol. 1989;20:537–63.

    Article  CAS  PubMed  Google Scholar 

  16. Hurley HJ, Witkowski JA. The dynamics of the eccrine sweating in man. I. Sweat delivery through myoepithelial contraction. J Invest Dermatol. 1962;39:329–38.

    Article  CAS  PubMed  Google Scholar 

  17. Lonsdale-Eccles A, Leonard N, Lawrence C. Axillary hyperhidrosis: eccrine or apocrine? Clin Exp Dermatol. 2003;28:2–7.

    Article  CAS  PubMed  Google Scholar 

  18. Lakraj AD, Moghimi N, Jabbari B. Hyperhidrosis: anatomy, pathophysiology and treatment with emphasis on the role of botulinum toxins. Toxins (Basel). 2013;5:821–40.

    Article  CAS  PubMed  Google Scholar 

  19. Elder DE, Elenitsas R, Rosenbach M, Murphy GF, Rubin AI, Xu X. Lever’s histopathology of the skin. 11th ed. Philadelphia: Lippincott Williams & Wilkins; 2014.

    Google Scholar 

  20. Sato K, Ohtsuyama M, Samman G. Eccrine sweat gland disorders. J Am Acad Dermatol. 1991;24(6):1010–4.

    Article  CAS  PubMed  Google Scholar 

  21. Naumann M. Hypersecretory disorders. In: Moore P, Naumann M, editors. Handbook of botulinum toxin treatment. 2nd ed. Oxford: Blackwell-Science; 2003. p. 343–59.

    Google Scholar 

  22. Sato K, Sato F. Effect of VIP on sweat secretion and cAMP accumulation in isolated simian eccrine glands. Am J Phys. 1987;253:R935–41.

    CAS  Google Scholar 

  23. Saadia D, Voustianiouk A, Wang AK, Kaufmann H. Botulinum toxin type a in primary palmar hyperhidrosis: randomized, single-blind, two-dose study. Neurology. 2001;57:2095–9.

    Article  CAS  PubMed  Google Scholar 

  24. Smith FC. Hyperhidrosis. Vasc Surg. 2013;31(5):251–5.

    Google Scholar 

  25. Schnider P, Binder M, Kittler H, Birner P, Starkel D, Wolff K, et al. A randomized, double-blind, placebo-controlled trial of botulinum a toxin for severe axillary hyperhidrosis. Br J Dermatol. 1999;140:677–80.

    Article  CAS  PubMed  Google Scholar 

  26. Champion RH. Disorders of sweat glands. In: Champion RH, Burton JL, Ebling FJG, editors. Textbook of dermatology, vol. 3. 5th ed. Oxford: Blackwell; 1992. p. 1758–9.

    Google Scholar 

  27. Almeida AT, Boraso RZ. Palmar hyperhidrosis. In: Almeida AT, Hexsel D, editors. Hyperhidrosis and botulinum toxin. São Paulo: Author’s Edition; 2004. p. 155–62.

    Google Scholar 

  28. Hexsel D, Ave BR, Hexsel C, Dal Forno T. Inguinal hyperidrosis. In: Almeida AT, Hexsel D, editors. Hyperhidrosis and botulinum toxin. São Paulo: Author’s Edition; 2003. p. 181–5.

    Google Scholar 

  29. Hexsel DM, Dal’Forno T, Hexsel CL. Inguinal, or Hexsel’s hyperhidrosis. Clin Dermatol. 2004;22:53–9.

    Article  PubMed  Google Scholar 

  30. Kreyden OP, Schmid-Grendelmeier P, Burg G. Idiopathic localized unilateral hyperhidrosis. Case report of successful treatment with botulinum toxin type A and review of the literature. Arch Dermatol. 2001;137:1622–5.

    Article  CAS  PubMed  Google Scholar 

  31. Kocyigit P, Akay BN, Saral S, Akbostanci C, Bostanci S. Unilateral hyperhidrosis with accompanying contralateral anhidrosis. Clin Exp Dermatol. 2009;34:e544–6.

    Article  CAS  PubMed  Google Scholar 

  32. Glaser DA, Herbert AA, Pariser DM, Solish N. Primary focal hyperhidrosis: scope of the problem. Cutis. 2007;79(5):5–17.

    PubMed  Google Scholar 

  33. Chopra KF, Evans T, Severson J, Tyring SK. Acute varicella zoster with postherpetic hyperhidrosis as the initial presentation of HIV infection. J Am Acad Dermatol. 1999;41:119–21.

    Article  CAS  PubMed  Google Scholar 

  34. Connor KM, Cook JL, Davidson JR. Botulinum toxin treatment of social anxiety disorder with hyperhidrosis: a placebo-controlled double-blind trial. J Clin Psychiatry. 2006;67:30–6.

    Article  CAS  PubMed  Google Scholar 

  35. Davidson JR, Foa EB, Connor KM, Churchill LE. Hyperhidrosis in social anxiety disorder. Prog Neuro-Psychopharmacol Biol Psychiatry. 2002;26:1327–31.

    Article  Google Scholar 

  36. Ruchinskas R. Hyperhidrosis and anxiety: chicken or egg? Dermatology. 2007;214:195–6.

    Article  PubMed  Google Scholar 

  37. Shaw JE, Parker R, Hollis S, Gokal R, Boulton AJ. Gustatory sweating in diabetes mellitus. Diabet Med. 1996;13:1033–7.

    Article  CAS  PubMed  Google Scholar 

  38. Blair D, Sagel J, Taylor I. Diabetic gustatory sweating. South Med J. 2002;95(3):360–2.

    Article  PubMed  Google Scholar 

  39. de Bree R, Van der Waal I, Leemans R. Management of Frey syndrome. Head Neck. 2007;29(8):773–8.

    Article  PubMed  Google Scholar 

  40. Baskan EM, Karli N, Baykara M, Tunali S. Localized unilateral hyperhidrosis and neurofibromatosis type I: case report of a new association. Dermatology. 2005;211:286–9.

    Article  PubMed  Google Scholar 

  41. Dua J, Grabczynska S. Eccrine nevus affecting the forearm of an 11-year-old girl successfully controlled with topical glycopyrrolate. Pediatr Dermatol. 2014;31(5):611–2.

    Article  PubMed  Google Scholar 

  42. Sen S, Chatterjee G, Mitra PK, Gangopadhyay A. Eccrine angiomatous naevus revisited. Indian J Dermatol. 2012;57(4):313–5.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Shah S, Boen M, Kenner-Bell B, Schwartz M, Rademaker A, Paller AS. Pachyonychia congenital in pediatric patients: natural history, features and impact. JAMA Dermatol. 2014;150(2):146–53. epublished:E1–7

    Article  PubMed  Google Scholar 

  44. Biju V, Sawhney MP, Vishal S. Ross syndrome with ANA positivity: a clue to possible autoimmune origin and treatment with intravenous immunoglobulin. Indian J Dermatol. 2010;55(3):274–6.

    Article  Google Scholar 

  45. Ballestero-Diez M, Garcia-Rio I, Dauden E, Corrales-Arroyo M, García-Díez A. Ross syndrome, an entity included within the spectrum of partial disautonomic syndromes. J Eur Acad Dermatol Venereol. 2005;19:729–31.

    Article  CAS  PubMed  Google Scholar 

  46. Lyra Rde M, Campos JR, Kang DW, Loureiro MP, Furian MB, Costa MG, et al. Guidelines for the prevention, diagnosis and treatment of compensatory hyperhidrosis. J Bras Pneumol. 2008;34(11):967–77.

    PubMed  Google Scholar 

  47. Cerfolio RJ, Milanez de Campos JR, Bryant AS, Connery CP, Miller DL, de Camp MM, et al. The Society of Thoracic Surgeons expert consensus for the surgical treatment of hyperhidrosis. Ann Thorac Surg. 2011;91:1642–8.

    Article  PubMed  Google Scholar 

  48. Drott C, Gothberg G, Claes G. Endoscopic transthoracic sympathectomy: an efficient and safe method for the treatment of hyperhidrosis. J Am Acad Dermatol. 1995;33:78–81.

    Article  CAS  PubMed  Google Scholar 

  49. Yazar S, Aslan C, Serdar ZA, Demirci GT, Tutkavul K, Babalik D. Ross syndrome: unilateral hyperhidrosis, Adie’s tonic pupils and diffuse areflexia. J Dtsch Dermatol Ges. 2010;8:1004–6.

    Google Scholar 

  50. Saito H, Sakuma H, Seno K. A case of traumatic high thoracic myelopathy presenting dissociated impairment of rostral sympathetic innervations and isolated segmental sweating on otherwise anhidrotic trunk. J Exp Med. 1999;188:95–102.

    CAS  Google Scholar 

  51. Nishimura J, Tamada Y, Iwase S, Kubo A, Watanabe D, Matsumoto Y. A case of lung cancer with unilateral anhidrosis and contralateral hyperhidrosis as the first clinical manifestation. J Am Acad Dermatol. 2011;65(2):438–40.

    Article  PubMed  Google Scholar 

  52. Smith CD. A hypothalamic stroke producing recurrent hemihyperhidrosis. Neurology. 2001;56:1394–6.

    Article  CAS  PubMed  Google Scholar 

  53. Talal AJ, Malik AK, Alsubai SM, Jawad ZR, Iqbal K, Khan M, Ali U, Ishaq M, Alsufyani S, Hadeed R, Alsufyani R, Ahmed T, Thakur H, Huang M, Antony I, Antony A, Bhullar F, Kotait L, Al-Ani. Post-acute COVID-19 syndrome and its prolonged effects: An updated systematic review. Ann Med Surg. 2022. 80103995-S2049080122007555 103995 https://doi.org/10.1016/j.amsu.2022.103995.

  54. Kamal SG, Vanichkachorn WP, Cheshire MD, Suarez S, Shelly GJ, Lamotte P, Sandroni EE, Benarroch SE, Berini JK, Cutsforth-Gregory EA, Coon ML, Mauermann PA, Low W, Singer. Autonomic dysfunction following COVID-19 infection: an early experience. Clin Auton Res. 2021;31(3):385–94. https://doi.org/10.1007/s10286-021-00803-8.

  55. Hornberger J, Grimes K, Naumann M, Glaser DA, Lowe NJ, Naver H, et al. Recognition diagnosis, and treatment of primary focal hyperhidrosis. J Am Acad Dermatol. 2004;51(2):274–86.

    Article  PubMed  Google Scholar 

  56. Vary JC Jr. Selected disorders of skin appendages—acne, alopecia, hyperhidrosis. Med Clin N Am. 2015;99(6):1195–211.

    Article  PubMed  Google Scholar 

  57. Solish N, Bertucci V, Dansereau A, Hong HC, Lynde C, Lupin M, et al. A comprehensive approach to the recognition, diagnosis, and severity-based treatment of focal hyperhidrosis: recommendations of the Canadian Hyperhidrosis Advisory Committee. Dermatol Surg. 2007;33:908–23.

    CAS  PubMed  Google Scholar 

  58. Hexsel D, Rodrigues TC, Soirefmann M, Zechmeister-Prado D. Recommendations for performing and evaluating the results of the minor test according to a sweating intensity visual scale. Dermatol Surg. 2010;36:120–2.

    Article  CAS  PubMed  Google Scholar 

  59. Steiner D. Quantitative sweats tests: iodine-starch and gravimetry. In: Almeida ART, Hexsel DM, editors. Hyperhidrosis and botulinum toxin. São Paulo: Edition of authors; 2004. p. 59–61.

    Google Scholar 

  60. Bahmer F, Sachse M. Hyperhidrosis area and severity index. Dermatol Surg. 2008;34:1744–5.

    CAS  PubMed  Google Scholar 

  61. Wechter T, Feldman SR, Taylor SL. The treatment of primary focal hyperhidrosis. Skin Ther Lett. 2019;24(1):1–7.

    Google Scholar 

  62. Gorelick J, Adam F. Diagnosis and management of primary hyperhidrosis: practical guidance and current therapy update. J Drugs Dermatol. 2020;19(7):704–10.

    Article  PubMed  Google Scholar 

  63. Naumann M, Dressler D, Hallett M, Jankovic J, Schiavo G, Segal KR, et al. Evidence-based review and assessment of botulinum neurotoxin for the treatment of secretory disorders. Toxicon. 2013;67:141–52.

    Article  CAS  PubMed  Google Scholar 

  64. 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;323:596–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  65. Heckmann M, Ceballos-Baumann AO, Plewig G. Botulinum toxin a for axillary hyperhidrosis (excessive sweating). N Engl J Med. 2001;344:488–93.

    Article  CAS  PubMed  Google Scholar 

  66. Odderson IR. Long-term quantitative benefits of botulinum toxin type A in the treatment of axillary hyperhidrosis. Dermatol Surg. 2002;28:480–3.

    PubMed  Google Scholar 

  67. TalaricoFilho S, Mendonça do Nascimento M, Sperandeo de Macedo F, De Sanctis Pecora C. A double-blind, randomized, comparative study of two type a botulinum toxins in the treatment of primary axillary hyperhidrosis. Dermatol Surg. 2007;33:S44–50.

    Article  CAS  PubMed  Google Scholar 

  68. Vadoud-Seyedi J, Simonart T. Treatment of axillary hyperhidrosis with botulinum toxin type A reconstituted in lidocaine or in normal saline: a randomized, side-by-side, double-blind study. Br J Dermatol. 2007;156:986–9.

    Article  CAS  PubMed  Google Scholar 

  69. Dressler D. Comparing Botox and Xeomin for axillary hyperhidrosis. J Neural Transm (Vienna). 2010;117(3):317–9.

    Article  PubMed  Google Scholar 

  70. Lowe NJ, Yamauchi PS, Lask GP, Patnaik R, Iyer S. Efficacy and safety of botulinum toxin type a in the treatment of palmar hyperhidrosis: a double-blind, randomized, placebo-controlled study. Dermatol Surg. 2002;28(9):822–7.

    PubMed  Google Scholar 

  71. Schnider P, Binder M, Auff E, Kittler H, Berger T, Wolff K. Double-blind trial of botulinum A toxin for the treatment of focal hyperhidrosis of the palms. Br J Dermatol. 1997;136(4):548–52.

    Article  CAS  PubMed  Google Scholar 

  72. Baumann L, Slezinger A, Halem M, Vujevich J, Mallin K, Charles C, et al. Double-blind, randomized, placebo-controlled pilot study of the safety and efficacy of Myobloc (botulinum toxin type B) for the treatment of palmar hyperhidrosis. Dermatol Surg. 2005;31(3):263–70.

    Article  CAS  PubMed  Google Scholar 

  73. Simonetta Moreau M, Cauhepe C, Magues JP, Senard JM. A double-blind, randomized, comparative study of Dysport vs. Botox in primary palmar hyperhidrosis. Br J Dermatol. 2003;149(5):1041–5.

    Article  CAS  PubMed  Google Scholar 

  74. Shelley WB, Hurley HJ Jr. Studies on topical antiperspirant control of axillary hyperhidrosis. Acta Derm Venereol. 1975;55:241–60.

    CAS  PubMed  Google Scholar 

  75. Walling HW, Swick BL. Treatment options for hyperhidrosis. Am J Clin Dermatol. 2011;12:285–95.

    Article  PubMed  Google Scholar 

  76. Flanagan KH, Glaser DA. An open-label trial of the efficacy of 15% aluminium chloride in 2% salicylic acid gel base in the treatment of moderate-to-severe primary axillary hyperhidrosis. J Drugs Dermatol. 2009;8:477–80.

    PubMed  Google Scholar 

  77. MacKenzie A, Burns C, Kavanagh G. Topical glycopyrrolate for axillary hyperhidrosis. Br J Dermatol. 2013;69:483–4.

    Article  Google Scholar 

  78. Glaser DA, Hebert AA, Nast A, Werschler WP, Green L, Mamelok R, et al. Topical glycopyrronium tosylate for the treatment of primary axillary hyperhidrosis: results from the ATMOS-1 and ATMOS-2 phase 3 randomized controlled trials. J Am Acad Dermatol. 2019;80(1):128–38. e2

    Article  CAS  PubMed  Google Scholar 

  79. Glaser DA. Oral medications. Dermatol Clin. 2014;32:527–32.

    Article  CAS  PubMed  Google Scholar 

  80. Stolman LP. Hyperhidrosis: medical and surgical treatment. Eplasty. 2008;8:e22.

    PubMed  PubMed Central  Google Scholar 

  81. Wolosker N, De Campos JRM, Kauffman P, Puech-Leão P. A randomized placebo controlled trial of oxybutynin for the initial treatment of palmar and axillary hyperhidrosis. J Vasc Surg. 2012;55:1696–700.

    Article  PubMed  Google Scholar 

  82. Wolosker N, Schvartsman C, Krutman M. Efficacy and quality of life outcomes of oxybutynin for treating palmar hyperhidrosis in children younger than 14 years old. Pediatr Dermatol. 2014;31:48–53.

    Article  PubMed  Google Scholar 

  83. Millán-Cayetano JF, Boz J, Rivas-Ruiz F, Blázquez-Sánchez N, Ibáñez CH, Troya-Martín M. Oral oxybutynin for the treatment of hyperhidrosis: outcomes after one-year follow-up. Australas J Dermatol. 2017;58(2):e31–5.

    Article  PubMed  Google Scholar 

  84. Pariser DM, Krishnaraja J, Tremblay TM, Rubison RM, Love TW, McGraw BF. Randomized, placebo- and active controlled crossover study of the safety and efficacy of THVD-102, a fixed-dose combination of oxybutynin and pilocarpine, in subjects with primary focal hyperhidrosis. J Drugs Dermatol. 2017;16(2):127–32.

    CAS  PubMed  Google Scholar 

  85. Stolman LP. Treatment of excess sweating of the palms by iontophoresis. Arch Dermatol. 1987;123:893–6.

    Article  CAS  PubMed  Google Scholar 

  86. Togel B, Greve B, Raulin C. Current therapeutic strategies for hyperhidrosis: a review. Eur J Dermatol. 2002;12:219–23.

    PubMed  Google Scholar 

  87. Karakoc Y, Aydemir EH, Kalkan MT, Unal G. Safe control of palmoplantar hyperhidrosis with direct electrical current. Int J Dermatol. 2002;41:602–5.

    Article  PubMed  Google Scholar 

  88. Rosen R, Stewart T. Results of a 10-year follow-up study of botulinum toxin A therapy for primary axillary hyperhidrosis in Australia. Intern Med J. 2018;48(3):343–7.

    Article  PubMed  Google Scholar 

  89. BOTOX® Cosmetic (onabotulinumtoxinA) for injection. FDA-approved. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/103000s5302lbl.pdf.

  90. Glaser DA, Mattox AR. Focal axillary hyperhidrosis. In: Carruthers J, Carruthers A, editors. Botulinum toxin: procedures in cosmetic dermatology series. 4th ed. New York, NY: Elsevier; 2018. p. 177–85.

    Google Scholar 

  91. Breidenbach MA, Brunger AT. New insights into clostridial neurotoxin-SNARE interactions. Trends Mol Med. 2005;11(8):377–81.

    Article  CAS  PubMed  Google Scholar 

  92. Perez-Bernal AM, Avalos-Peralta P, Moreno-Ramirez D, Camacho F. Treatment of palmar hyperhidrosis with botulinum toxin type A: 44 months of experience. J Cosmet Dermatol. 2005;4(3):163–6.

    Article  PubMed  Google Scholar 

  93. Solomon BA, Hayman R. Botulinum toxin type A therapy for palmar and digital hyperhidrosis. J Am Acad Dermatol. 2000;42(6):1026–9.

    Article  CAS  PubMed  Google Scholar 

  94. Glaser DA, Mattox AR. Primary focal palm, sole, craniofacial, and compensatory hyperhidrosis. In: Cohen JL, Ozog DM, editors. Botulinum toxins: cosmetic and clinical applications. John Wiley & Sons, Ltd.: Hoboken, NJ; 2017. p. 299–315.

    Chapter  Google Scholar 

  95. Komericki P, Ardjomand N. Hyperhidrosis of face and scalp: repeated successful treatment with botulinum toxin type A. Indian J Dermatol Venereol Leprol. 2012;78(2):201–2.

    Article  PubMed  Google Scholar 

  96. Kim WO, Kil HK, Yoon KB, Noh KU. Botulinum toxin: a treatment for compensatory hyperhidrosis in the trunk. Dermatol Surg. 2009;35(5):833–8.

    Article  CAS  PubMed  Google Scholar 

  97. Galadari H, Galadari I, Smit R, Prygova I, Redaelli A. Treatment approaches and outcomes associated with the use of abobotulinumtoxinA for the treatment of hyperhidrosis: a systematic review. J Am Acad Dermatol. 2021;85(5):1121–9.

    Article  CAS  PubMed  Google Scholar 

  98. Dressler D. Routine use of Xeomin in patients previously treated with Botox: long term results. Eur J Neurol. 2009;16(Suppl. 2):2–5.

    Article  PubMed  Google Scholar 

  99. Yamauchi PS, Lowe NJ. Botulinum toxin types A and B: comparison of efficacy, duration, and dose-ranging studies for the treatment of facial rhytides and hyperhidrosis. Clin Dermatol. 2004;22(1):34–9.

    Article  PubMed  Google Scholar 

  100. Dressler D, Saberi FA, Benecke R. Botulinum toxin type B for treatment of axillar hyperhidrosis. J Neurol. 2002;249(12):1729–32.

    Article  CAS  PubMed  Google Scholar 

  101. Nawrocki S, Cha J. Botulinum toxin: pharmacology and injectable administration for the treatment of primary hyperhidrosis. J Am Acad Dermatol. 2020;82(4):969–79.

    Article  CAS  PubMed  Google Scholar 

  102. Dressler D, Hallett M. Immunological aspects of Botox, Dysport and Myobloc/NeuroBloc. Eur J Neurol. 2006;13(Suppl. 1):11–5.

    Article  PubMed  Google Scholar 

  103. Almeida AT, Cernea SS. Tratamento da hiperidrose. In: Hexsel D, Almeida AT, editors. Uso cosmético da toxina botulínica. Porto Alegre: AGE; 2002. p. 226–7.

    Google Scholar 

  104. Hexsel DM, Soirefmann M, Rodrigues TC, do Prado DZ. Increasing the field effects of similar doses of Clostridium botulinum type A toxin-hemagglutinin complex in the treatment of compensatory hyperhidrosis. Arch Dermatol. 2009;145(7):837–40.

    Article  PubMed  Google Scholar 

  105. Hexsel D, Soirefmann M, Porto MD, Schilling-Souza J, Siega C. Fields of anhidrotic effects of abobotulinumtoxin A in patients with compensatory hyperhidrosis. Dermatol Surg. 2015;41:S93–S100.

    Article  CAS  PubMed  Google Scholar 

  106. Heckmann M, Plewig G. Low-dose efficacy of botulinum toxin A for axillary hyperhidrosis. Arch Dermatol. 2005;141:1256–9.

    Article  Google Scholar 

  107. Lowe NJ, Glaser DA, Eadie N, Daggett S, Kowalski JW, Lai PY. Botulinum toxin type a in the treatment of primary axillary hyperhidrosis: a 52-week multicenter double-blind, randomized, placebo-controlled study of efficacy and safety. J Am Acad Dermatol. 2007;56:604–11.

    Article  PubMed  Google Scholar 

  108. Gregoriou S, Rigopoulos D, Makris M, Liakou A, Agiosofitou E, Stefanaki C, Kontochristopoulos G. Effects of botulinum toxin-a therapy for palmar hyperhidrosis in plantar sweat production. Dermatol Surg. 2010;36(4):496–8.

    Article  CAS  PubMed  Google Scholar 

  109. Dressler D, Adib SF. Towards a dose optimisation of botulinum toxin therapy for axillary hyperhidrosis: comparison of different Botox(®) doses. J Neural Transm. 2013;120(11):1565–7.

    Article  CAS  PubMed  Google Scholar 

  110. Brehmer F, Lockmann A, Gronemeyer LL, Kretschmer L, Schon MP, Thoms KM. Repetitive injections of botulinum toxin A continuously increase the duration of efficacy in primary axillary hyperhidrosis: a retrospective analysis in 101 patients. J Dtsch Dermatol Ges. 2015;13(8):799–805.

    PubMed  Google Scholar 

  111. Lecouflet M, Leux C, Fenot M, Celerier P, Maillard H. Duration of efficacy increases with the repetition of botulinum toxin A injections in primary axillary hyperhidrosis: a study in 83 patients. J Am Acad Dermatol. 2013;69(6):960–4.

    Article  CAS  PubMed  Google Scholar 

  112. Cervantes J, Perper M, Eber AE, Fertig RM, Tsatalis JP, Nouri K. Laser treatment of primary axillary hyperhidrosis: a review of the literature. Lasers Med Sci. 2018;33(3):675–81.

    Article  PubMed  Google Scholar 

  113. Letada PR, Landers JT, Uebelhoer NS, Shumaker PR. Treatment of focal axillary hyperhidrosis using a long pulsed Nd: YAG 1064 nm laser at hair reduction settings. J Drugs Dermatol. 2012;11:59–63.

    PubMed  Google Scholar 

  114. Goldman A, Wollina U. Subdermal Nd-YAG laser for axillary hyperhidrosis. Dermatol Surg. 2008;34(6):756–62.

    CAS  PubMed  Google Scholar 

  115. Aydin F, Pancar GS, Senturk N, Bek Y, Yuksel EP, Canturk T, et al. Axillary hair removal with 1064-nm Nd:YAG laser increases sweat production. Clin Exp Dermatol. 2010;35:588–92.

    Article  CAS  PubMed  Google Scholar 

  116. Bechara FG, Georgas D, Sand M, Stücker M, Othlinghaus N, Altmeyer P, et al. Effects of a long-pulsed 800-nm diode laser on axillary hyperhidrosis: a randomized controlled half-side comparison study. Dermatol Surg. 2012;38(5):736–40.

    Article  CAS  PubMed  Google Scholar 

  117. Hong HC, Lupin M, O’Shaughnessy KF. Clinical evaluation of a microwave device for treating axillary hyperhidrosis. Dermatol Surg. 2012;38:728–35.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  118. Lee S, Chang K, Suh D, Song KY, Ryu HJ. The efficacy of a microwave device for treating axillary hyperhidrosis and osmidrosis in Asians: a preliminary study. J Cosmet Laser Ther. 2013;15:255–9.

    Article  PubMed  Google Scholar 

  119. Glaser DA, Coleman WP, Fan LK, Kaminer MS, Kilmer SL, Nossa R, et al. A randomized, blinded clinical evaluation of a novel microwave device for treating axillary hyperhidrosis: the dermatologic reduction in underarm perspiration study. Dermatol Surg. 2012;38:185–91.

    Article  CAS  PubMed  Google Scholar 

  120. Sanchez-Carpintero I, Martin-Gorgojo A, Ruiz-Rodriguez R. Microwave treatment for axillary hyperhidrosis and bromhidrosis. Actas Dermosifiliogr. 2017;108(5):418–22.

    Article  CAS  PubMed  Google Scholar 

  121. Nestor MS, Park H. Safety and efficacy of micro-focused ultrasound plus visualization for the treatment of axillary hyperhidrosis. J Clin Aesthet Dermatol. 2014;7(4):14–21.

    PubMed  PubMed Central  Google Scholar 

  122. Commons GW, Lim AF. Treatment of axillary hyperhidrosis/bromidrosis using VASER ultrasound. Aesthetic Plast Surg. 2009;33(3):312–23.

    Article  PubMed  Google Scholar 

  123. Feldmeyer L, Bogdan I, Moser A, Specker R, Kamarashev J, French LE, et al. Short- and long-term efficacy and mechanism of action of tumescent suction curettage for axillary hyperhidrosis. J Eur Acad Dermatol Venereol. 2015;29(10):1933–7.

    Article  CAS  PubMed  Google Scholar 

  124. Ojimba TA, Cameron AE. Drawbacks of endoscopic thoracic sympathectomy. Br J Surg. 2004;91:264–9.

    Article  CAS  PubMed  Google Scholar 

  125. Bell D, Jedynak J, Bell R. Predictors of outcome following endoscopic thoracic sympathectomy. ANZ J Surg. 2014;84:68–72.

    Article  PubMed  Google Scholar 

  126. Cerfolio RJ, De Campos JR, Bryant AS, Connery CP, Miller DL, DeCamp MM, et al. The Society of Thoracic Surgeons expert consensus for the surgical treatment of hyperhidrosis. Ann Thorac Surg. 2011;91(5):1642–8.

    Article  PubMed  Google Scholar 

  127. Stefaniak TJ, Cwigon M. Long-term results of thoracic sympathectomy for primary hyperhidrosis. Pol Przegl Chir. 2013;85(5):247–52.

    Article  PubMed  Google Scholar 

  128. Yang Y, Zeng L, An Z, Wang L, Hu J. Minimally invasive thoracic sympathectomy for palmar hyperhidrosis via a single unilateral incision approach by the pleura videoscope. J Laparoendosc Adv Surg Tech A. 2014;24(5):328–32.

    Article  PubMed  Google Scholar 

  129. Zacherl J, Huber ER, Imhof M, Plas EG, Herbst F, Függer R. Long-term results of 630 thoracoscopic sympathicotomies for primary hyperhidrosis: the Vienna experience. Eur J Surg Suppl. 1998;580:43–6.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Doris Hexsel .

Editor information

Editors and Affiliations

Glossary

Apocrine sweat glands

Larger sweat glands that occur in hair follicles. They appear after puberty.

Apoeccrine sweat glands

Contain morphological features common to the eccrine and apocrine sweat glands.

Eccrine sweat glands

Small sweat glands that produce a fluid secretion without removing cytoplasm from the secreting cells and that are restricted to the human skin.

Hyperhidrosis

Sweating greater than necessary for the maintenance of normal body thermoregulation.

Primary hyperhidrosis

Excessive sweating in specific regions of the body and not caused by other medical conditions or by medications.

Secondary hyperhidrosis

Excessive sweating caused by medications or medical conditions.

Sympathectomy

Procedures that break the sympathetic innervation thereby blocking stimulation of eccrine glands.

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Hexsel, D., Camozzato, F.O. (2023). Hyperhidrosis. In: Rangel Bonamigo, R. (eds) Dermatology in Public Health Environments. Springer, Cham. https://doi.org/10.1007/978-3-031-13505-7_76

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-13505-7_76

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-13504-0

  • Online ISBN: 978-3-031-13505-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics