Efficacy of photodynamic therapy for treatment of primary palmar hyperhidrosis

Abstract

Palmar hyperhidrosis represents a condition with a significant cosmetic and psychological burden. Various treatment modalities are available; however, searching for newer options to meet patients' needs and expectations is encouraged. The study aimed to evaluate the efficacy of photodynamic therapy (PDT) for treatment of primary palmar hyperhidrosis. Two different photosensitizers for PDT were evaluated: eosin Y, and methylene blue. The study focused on the clinical efficacy, patient's satisfaction, and the time and number of sessions needed to achieve a satisfactory response. Twenty patients with primary palmar hyperhidrosis were enrolled in a single‐center clinical study. Patients were treated with PDT for a maximum of eight sessions. Two photosensitizers were tested: eosin Y, and methylene blue for the right and left hand, respectively. The Hyperhidrosis disease severity scale (HDSS), and Sweating Intensity Visual Scale of Minor's test were used for assessment. Photodynamic therapy effectively reduced the severity scores of hyperhidrosis with comparable results between the two photosensitizers. The treatment effect was maintained up to 3 months after the last procedure. Photodynamic therapy is a good treatment option for primary palmar hyperhidrosis with results maintainable for 3 months after the treatment end.

Transfersomal eosin topical delivery assisted by fractional CO2 laser for photodynamic treatment of palmar hyperhidrosis: case study

“…Previous studies on hyperhidrosis treatment used liposomes, to enhance the drug delivery through palmar skin [ 11 , 15 ]. In this case study, we used transfersomes as it was proved that transfersomes were superior to liposomes in the dermal and transdermal delivery [ 16 ].…”

“…PDT using EY as a PS (PDT-EY) was used previously for the treatment of both axillary [ 10 ] and palmar hyperhidrosis [ 11 ]. The results obtained from those studies revealed that the management of palmar hyperhidrosis was more difficult and took a longer time and higher number of sessions (8 sessions).…”

“…The assessment was done by starch iodine test to determine the area of hyperhidrosis before and after treatment. The sweating intensity was determined based on the color intensity of the starch iodine test according to the 5-grades Sweating Intensity Visual Scale [ 11 ], where Grade 0 indicates no sweating, grade 1 indicates minimal sweating, grade 2 indicates mild sweating, grade 3 indicates moderate sweating, grade 4indicates intense sweating, and grade 5 indicates over-sweating.…”

“…Eosin yellow (EY) is a hydrophilic dye that was clinically approved for many clinical applications and exhibited marked efficiency as a photosensitizer in PDT of many skin disorders [ 9 ]. PDT using EY has been used successfully for the treatment of axillary hyperhidrosis by the author [ 10 ] and for the treatment of palmar hyperhidrosis [ 11 ]; however, palmar hyperhidrosis is still challenging due to the increased thickness of the palmar skin.…”

Impact of endoscopic thoracic R4 sympathicotomy combined with R3 ramicotomy for primary palmar hyperhidrosis

“…The treatment for PPH comprises surgical and conservative traditional clinical therapies. Conservative clinical therapies contain skin application of antiperspirant agents, anticholinergic drugs, iontophoresis, Botulinum injections, photodynamic therapy and others (3)(4)(5)(6)(7). Regardless, all of these therapies have a temporary duration of effect, and some drugs may generate serious side effects if used for an extended period of time.…”