Interventional management of hyperhidrosis in secondary care: a systematic review

Wade, Ros; Llewellyn, Alexis; Jones-Diette, Julie; Wright, Kath; Rice, Stephen; Layton, Alison M.; Levell, N. J.; Craig, Dawn; Woolacott, Nerys

doi:10.1111/bjd.16558

Cited by 29 publications

(37 citation statements)

References 51 publications

(73 reference statements)

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“…2,5,6 Most recommendations are mainly based on expert consensus as neither revised guidelines nor approval by the Food and Drug Administration (FDA) exist to guide therapeutic decision-making. [5][6][7][8] Topical Therapies…”

Section: Current Treatment Of Palmar Hyperhidrosismentioning

confidence: 99%

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<p>Management Strategies Of Palmar Hyperhidrosis: Challenges And Solutions</p>

Gregoriou

Sidiropoulou

Kontochristopoulos

et al. 2019

CCID

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Palmar hyperhidrosis is a potentially disabling condition for which management remains a therapeutic challenge. Given the significant impact on quality of life, various treatment options are available, ranging from topical agents and medical devices to systemic therapies and surgical interventions. Nonsurgical approaches, i.e. topical antiperspirants, botulinum toxin injections, iontophoresis, and systemic agents, are all supported by the current literature. Patients with mild-to-moderate disease can often benefit from topical therapies only. As disease severity progresses, systemic oral medication, such as anticholinergic drugs, usually becomes necessary. Last-line surgical approaches (sympathetic denervation) should be reserved for severe refractory cases. Recently, therapeutic strategies have been evolving with several new agents emerging as promising alternatives in clinical trials. In practice, however, each modality comes with its own benefits and risks. An individual therapeutic ladder is generally recommended, taking into account disease severity, benefit-to-risk profile, treatment cost, patient preference, and clinician expertise. This review will provide an update on current and emerging concepts of management for excessive hand sweating to help clinicians optimize therapeutic decision-making.

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Section: Current Treatment Of Palmar Hyperhidrosismentioning

confidence: 99%

“…8,19 Tap water iontophoresis has long been recognized to successfully inhibit palmar sweating. 7,18,19,21 Favorable results generally appear in at least 81% of PH patients, with symptoms usually returning at 2-14 weeks after the last session. 11,18 However, low mineral levels in tap water may lead to insufficient current flow.…”

Section: Iontophoresismentioning

confidence: 99%

<p>Management Strategies Of Palmar Hyperhidrosis: Challenges And Solutions</p>

Gregoriou

Sidiropoulou

Kontochristopoulos

et al. 2019

CCID

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“…2 The supportive evidence for BoNT injection in the treatment of palmoplantar PH, however, remains insufficient, and the quality thereof is very low. 2 Furthermore, pain is major side effect of this treatment, which requires multiple injections on the axillae, palms, and soles, despite pretreatment with localized anesthesia and using needles small in diameter. 8 Although much effort has been expended to deliver BoNT using non-invasive techniques to target layers of the skin, the results thereof have failed to provide any definitive conclusions.…”

mentioning

confidence: 99%

Pressure‐and dose‐controlled, needle‐free, transcutaneous pneumatic injection of botulinum neurotoxin‐A for the treatment of primary axillary and palmoplantar hyperhidrosis

Kim¹,

Lee²,

Lee³

et al. 2020

Skin Research and Technology

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Primary hyperhidrosis (PH) is a common, uncontrollable, excessive sweating disorder along the axillary area or palms, without associated systemic disorders. 1 Primary treatment options for this condition involve lifestyle changes (eg, losing weight, avoiding stimulant-containing foods, and restricting provocative clothing) and applying topical antiperspirants, including aluminum chloride, glycopyrrolate, and formaldehyde solution. 2,3 Secondary non-surgical treatment options include tap-water iontophoresis, systemic anticholinergics, energy-delivering modalities, including neodymium-doped yttrium aluminum garnet (Nd:YAG) lasers, long-pulsed diode lasers, and radiofrequency, microwave, and ultrasound devices, and botulinum neurotoxin (BoNT) injections. 2-5 Otherwise, surgical treatment options can provide promising therapeutic effects on axillary or palmar PH and encompass the curettage removal of axillary subcutaneous

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“…This issue of the BJD includes an important systematic review regarding the effectiveness and safety of treatments for refractory primary hyperhidrosis in secondary care in the U.K . Primary hyperhidrosis is a condition that can be associated with significant negative socioeconomic and psychosocial effects .…”

mentioning

confidence: 99%

“…In this paper, Wade et al . have highlighted substantial heterogeneity between studies, an issue that is not uncommon across therapeutic clinical trials and one that makes comparison of interventions and outcome measures problematic.…”

mentioning

confidence: 99%