Primary Pediatric Hyperhidrosis: A Review of Current Treatment Options

Gelbard, Christina M.; Epstein, Hayley; Hebert, Adelaide A.

doi:10.1111/j.1525-1470.2008.00782.x

Cited by 57 publications

(55 citation statements)

References 32 publications

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“…18 Differently from palmar hyperhidrosis, in which symptoms most frequently start in childhood, patients with facial hyperhidrosis start experiencing its symptoms in adulthood. 19,20 For this reason, most patients that seek treatment are adults in their forties. There is no female predominance as seen in other sites of hyperhidrosis, probably because this type of excessive sweating has greater repercussions in men's daily lives than in women's.…”

Section: Discussionmentioning

confidence: 99%

The use of oxybutynin for treating facial hyperhidrosis

Wolosker

Campos

Kauffman

et al. 2011

An. Bras. Dermatol.

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BACKGROUND: Facial hyperhidrosis is a disease that may lead patients to serious emotional disturbances. Video-assisted thoracic sympathectomy provides excellent resolution of facial hyperhidrosis, but is associated with certain complications. The most frequent and important complication is compensatory hyperhidrosis. Especially in patients who have undergone resection of the second thoracic ganglion, the risk of severe compensatory hyperhidrosis is higher, which may cause dissatisfaction with the procedure. OBJECTIVE: The aim of this study was to evaluate the efficacy of the use of low doses of oxybutynin in treating facial hyperhidrosis as well as the level of patient satisfaction with its use. METHODS: 25 patients with facial hyperhidrosis were treated with oxybutynin. The patients underwent 2 evaluations: before and after treatment. These evaluations were used to assess the patients' clinical improvement and quality of life. RESULTS: We observed that more than 75% of the patients evolved with an improvement in facial hyperhidrosis, and 52% of them presented a great improvement. CONCLUSION: Treatment of facial hyperhidrosis with oxybutynin is a good alternative to sympathectomy, since it presents good results and improves quality of life, in addition to not exposing patients to the risk of experiencing the side effects of sympathectomy. Keywords: Advanced treatment; Clinical protocols; Hyperhidrosis; Indicators of quality of life; Sympathectomy; Sweating Resumo: FUNDAMENTOS: Hiperidrose facial é uma doença que pode levar os pacientes a sérios distúrbios emocionais. A simpatectomia torácica vídeo-assistida proporciona excelente resolução da hiperidrose facial, mas está associada a algumas complicações, sendo a mais freqüente e mais importante a hiperidrose compensatória. Especialmente em pacientes submetidos à ressecção do segundo gânglio torácico, o risco de hiperidrose compensatória grave é maior, o que pode causar insatisfação com o procedimento. OBJETIVO: O objetivo deste estudo foi avaliar a eficácia e a satisfação dos pacientes com o uso da oxibutinina em doses baixas para tratar a hiperidrose facial em uma série grande de pacientes. MÉTODOS: 25 pacientes com hiperidrose facial foram tratados com oxibutinina. Os pacientes foram submetidos a duas avaliações: antes e depois do tratamento. Estas foram usadas para avaliar a melhoria clínica e a qualidade de vida. RESULTADOS: Observou-se que mais de 75% dos pacientes evoluíram com melhora na hiperidrose facial, sendo que 52% deles apresentaram uma grande melhora. CONCLUSÃO: O tratamento da hiperidrose facial com oxibutinina é uma boa alternativa à simpatectomia, visto que apresenta bons resultados e melhora a qualidade de vida, e os pacientes não correm o risco dos efeitos colaterais da simpatectomia.

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Section: Discussionmentioning

confidence: 99%

The use of oxybutynin for treating facial hyperhidrosis

Wolosker

Campos

Kauffman

et al. 2011

An. Bras. Dermatol.

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“…No painful stress was present in our patients as we infiltrated the tissues with bupivacaine (19) up to the endothoracic fascia before skin incision for placement of the trocar and nonsteroidal antiinflammatory agents were given postoperatively. Other complications of the procedure are reported as pneumothorax, intrathoracic bleeding, and gustatory sweating (2,4,5,20,21). In our series one patient required insertion of a chest tube due to pneumothorax.…”

Section: Discussionmentioning

confidence: 90%

“…Surgical treatment for palmar or axillary hyperhidrosis is a permanent solution for adolescents who have tried other treatment options (3,5). In the literature, use of thoracoscopy for thoracic sympathectomy was defined by Kux (11).…”

Section: Discussionmentioning

confidence: 99%

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Single port thoracoscopic sympathectomy for primary palmar hyperhidrosis in adolescence

Günal¹,

Özpolat²,

Günal³

et al. 2014

Turk J Med Sci

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IntroductionHyperhidrosis is a health problem having negative effects on adolescent quality of life, affecting daily social activities or educational life. Primary focal hyperhidrosis (PFH) is often observed in axillary, palmar, plantar, and craniofacial regions and more than one region can be involved (1). There is still no consensus about the mechanism of hyperhidrosis in adolescents. The prevalence is reported as 0.6%-1.0% in young populations (2).Thoracoscopic sympathectomy, which is accepted as the gold standard for the permanent cure of PFH, is achieved by interruption of impulse transmission from sympathetic ganglia to the sweat glands (2,3). A few studies reported that surgery should be performed before adulthood, emphasizing that adolescents tolerate side effects better than adults (1,3-7).Among adolescents, primary palmar hyperhidrosis (PPH) is widely disregarded and undertreated. To the best of our knowledge, there is no study reporting PPH treatment with single port video-assisted thoracoscopic sympathectomy (VTS) in adolescents in Turkey. Herein, we report our experience and short-term outcomes of this treatment, where the symptom resolution, intraoperative and postoperative complications, patient satisfaction, and subsequent compensatory sweating (CS) are analyzed. Materials and methodsSeven adolescents who underwent VTS for PPH between March 2011 and July 2012 were included. The indications for operation in our patients were chosen according to the Multi-Specialty Working Group on the Recognition, Diagnosis, and Treatment of Primary Focal Hyperhidrosis criteria: focal, visible, excessive sweating of at least 6 months in duration without an underlying cause, plus at least 2 of the following characteristics: a distribution that is bilateral and relatively symmetric, impairment of daily activities, at least 1 episode per week, onset before 25 years of age, family history of PFH, or focal sweating that ceases during sleep (8).Data were collected retrospectively. The chief complaint of patients was palmar hyperhidrosis. Additional axillary hyperhidrosis was present in 6 patientsAim: Hyperhidrosis is defined as excessive sweating beyond the physiologic needs of a person. Palmar hyperhidrosis in the adolescent period may have an impact on school work and may cause psychological problems. In this study we aim to increase awareness of this disregarded problem. Materials and methods:We explicated the early outcomes of 7 consecutive adolescents, where single port video-assisted thoracoscopic sympathectomy was performed for primary palmar hyperhidrosis. Patients were evaluated for symptom resolution, which was defined as complete dryness, patient satisfaction, operative complications, and compensatory sweating.Results: In total 13 thoracoscopic procedures were done in 7 adolescents, consisting of 4 girls and 3 boys (median age = 16 years). Thoracoscopic sympathectomy achieved immediate complete dryness and all were very satisfied with the outcome of the procedure. Compensatory sweating was defined as mild by 4...

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“…The sudomotor efferents, in contrast to the usual adrenergic efferents, secrete acetylcholine, which acts on the muscarinic M3 receptors on eccrine sweat glands, except for a few adrenergic fibers over the palms and soles. Emotional sweating shares the peripheral pathways of thermoregulatory sweating, but is controlled centrally through the amygdala, prefrontal cortex, insular cortex, and anterior cingulate cortex, and affects mainly the sweat glands in the face, axillae, palms, and soles [2] . Abnormal excessive sweating is known as hyperhidrosis, and can be generalized or focal in nature.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Paroxetine in Primary Palmoplantar Hyperhidrosis Occurring with Juvenile Myoclonic Epilepsy

Katshu

Bhattacharya²,

Nizamie³

2011

Dermatology

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Primary palmoplantar hyperhidrosis (PPH) is believed to be a dysfunction of emotional sweating, with an estimated prevalence of around 3%. Several treatment options including topical antiperspirants, tap water iontophoresis, botulinum toxin injections, oral anticholinergics, and tricyclic antidepressants are available, each with a significant adverse event profile. For the first time, we report a PPH patient with comorbid juvenile myoclonic epilepsy (JME) treated successfully with a combination of paroxetine and divalproex sodium. Paroxetine resulted in improvement in PPH, possibly through its anticholinergic and/or noradrenergic actions. Though the occurrence of PPH and JME together seems to be a chance association, some common frontal lobe mechanisms may be involved that need to be explored further.

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Primary Pediatric Hyperhidrosis: A Review of Current Treatment Options

Cited by 57 publications

References 32 publications

The use of oxybutynin for treating facial hyperhidrosis

The use of oxybutynin for treating facial hyperhidrosis

Single port thoracoscopic sympathectomy for primary palmar hyperhidrosis in adolescence

Efficacy of Paroxetine in Primary Palmoplantar Hyperhidrosis Occurring with Juvenile Myoclonic Epilepsy

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