Posts

Posted on

Living Through Sweat: A Qualitative Study of the Pre-Surgical Decision-Making Trajectory in Patients with Palmar Hyperhidrosis

Patient Prefer Adherence. 2026 May 4;20:589191. doi: 10.2147/PPA.S589191. eCollection 2026.

ABSTRACT

PURPOSE: This study aimed to explore the dynamic and ambivalent pre-surgical decision-making process of patients with palmar hyperhidrosis (PH), focusing on the “anxiety-sweating” feedback loop and the psychological factors influencing their treatment choices, particularly the interplay between psychological distress and the decision to pursue surgery.

PATIENTS AND METHODS: We conducted a qualitative descriptive phenomenological study in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ). Semi-structured in-depth interviews were conducted with 19 adults who had lived with PH for more than 10 years and were considering surgical treatment. All interviews were conducted before surgery. Data were analyzed using NVivo 11 software and Colaizzi’s seven-step phenomenological method.

RESULTS: Analysis revealed a four-stage pre-surgical journey. First, patients initially normalized excessive hand sweating as a personal difference or familial trait, but gradually developed disease awareness as symptoms persisted and intensified. Second, PH imposed a substantial psychosocial burden, including functional limitations in study, work, and daily life, as well as reduced self-confidence, anticipatory anxiety, and social avoidance. Many participants described a self-reinforcing “anxiety-sweating” vicious cycle. Third, dissatisfaction with conservative treatments and increasing access to treatment-related information prompted patients to move from temporary coping strategies toward consideration of more durable interventions. Fourth, surgical deliberation was characterized by ambivalence: patients hoped surgery would relieve symptoms and restore social confidence, while also expressing concerns regarding compensatory sweating, postoperative discomfort, and recovery.

CONCLUSION: The pathway toward surgical consideration in patients with palmar hyperhidrosis was a dynamic and ambivalent process shaped by symptom normalization, psychosocial burden, prior treatment experiences, and concerns about surgical risks. These findings highlight the importance of addressing psychological and social experiences alongside technical counseling and support the value of shared decision-making in pre-surgical care.

PMID:42109704 | PMC:PMC13155398 | DOI:10.2147/PPA.S589191

Posted on

The use of an objective method (continuous exosomatic electrodermal activity without external stimuli) to evaluate patients with hyperhidrosis undergoing video-assisted sympathectomy

Einstein (Sao Paulo). 2026 Apr 27;24:eAO1266. doi: 10.31744/einstein_journal/2026AO1266. eCollection 2026.

ABSTRACT

OBJECTIVE: To analyze continuous exosomatic electrodermal activity (EDA) without external stimuli (EDAcw) in patients with primary hyperhidrosis before and after sympathectomy.

METHODS: This prospective study included 28 participants, categorized into two groups. The first group comprised 18 patients with palmoplantar hyperhidrosis who underwent bilateral thoracic sympathectomy. The second group (control) consisted of 10 patients. Two questionnaires were administered: the Control Group completed them once, whereas the Sympathectomy Group completed them preoperatively, and on the first and thirtieth postoperative days. Sweating was evaluated by measuring EDAcw using an MP36R biosensor. Measurements were obtained from the hands and feet for 5 min without external stimuli in an air-conditioned environment and were performed preoperatively, and on the first and thirtieth postoperative days. Anthropometric, clinical, and surgical data were collected, and no significant sociodemographic differences were observed between the groups.

RESULTS: In the Sympathectomy Group, quality of life improved, and sweating reduced. During preoperative assessment, EDA was higher in the hands and feet of patients with hyperhidrosis than in the Control Group. Postoperatively, EDA in the hands decreased, with 100% of the patients showing a decrease in sweating. For the feet, 67% of the patients reported reduced sweating, and 44% showed a statistically significant decline in EDA.

CONCLUSION: Continuous exosomatic EDA measurement without external stimuli is a suitable method for assessing patients with palmoplantar hyperhidrosis and shows appropriate clinical correlation.

PMID:42054168 | DOI:10.31744/einstein_journal/2026AO1266

Posted on

Managing Antidepressant-Induced Hyperhidrosis With Vitamin E: An Over-the-Counter Supplement-Based Approach

Clin Case Rep. 2026 Mar 11;14(3):e71979. doi: 10.1002/ccr3.71979. eCollection 2026 Mar.

ABSTRACT

Excessive sweating is a common side effect of antidepressants, affecting approximately 22% of patients. Antidepressant-induced excessive sweating (ADIES) can significantly impair quality of life and medication adherence. This case report explores the use of Vitamin E as a novel adjunct treatment for ADIES. A woman in her 30s with major depressive disorder experienced significant improvement in depressive symptoms with venlafaxine but developed distressing night sweats at higher doses. Given the patient’s reluctance to switch to a different antidepressant and to reduce polypharmacy, a trial of over-the-counter Vitamin E was initiated based on its prior evidence in managing hot flashes in postmenopausal women. After 3 months, the patient reported a significant reduction in sweating, as measured by validated symptom severity scales (CGI-S and HDSS). The case highlights Vitamin E as a potentially effective, low-risk, and accessible option for ADIES, especially for patients at risk for polypharmacy. While larger studies are needed, Vitamin E may offer a simple strategy for improving quality of life and medication adherence.

PMID:42016646 | PMC:PMC13093336 | DOI:10.1002/ccr3.71979

Posted on

Efficacy and Safety of Topical Anticholinergics in the Treatment of Primary Axillary Hyperhidrosis: A Systematic Review and Meta-analysis

Clin Drug Investig. 2026 Apr 16. doi: 10.1007/s40261-026-01550-2. Online ahead of print.

ABSTRACT

BACKGROUND: Topical anticholinergic agents are non-invasive treatment options for primary axillary hyperhidrosis (PAH). Sofpironium bromide was recently approved by the US Food and Drug Administration (FDA). A comprehensive evaluation of the efficacy and safety of available topical anticholinergics may inform clinical practice.

OBJECTIVES: To assess the efficacy and safety of topical anticholinergic therapies for PAH through systematic review and meta-analysis of randomized controlled trials (RCTs).

METHODS: Five databases were searched on September 9, 2024. Primary outcomes included a ≥2-point improvement in the Hyperhidrosis Disease Severity Scale (HDSS) and ≥50% reduction in gravimetric sweat production (GSP). Secondary outcomes included subjective symptom improvement and objective sweat reduction. Safety outcomes included treatment-emergent adverse events (TEAEs), anticholinergic-related adverse events, and local application site reactions. The review protocol was registered in PROSPERO (CRD42024583376).

RESULTS: Eight RCTs (n = 1921) that evaluated glycopyrronium, sofpironium bromide, and umeclidinium were included. Topical agents significantly outperformed placebos for HDSS ≥2-point improvement (risk ratio [RR]: 2.40; 95% confidence interval [CI]: 2.01-2.86) and GSP ≥50% reduction (RR: 1.43; 95% CI: 1.21-1.70). Sofpironium was the most effective HDSS treatment, whereas glycopyrronium showed highest efficacy against GSP. Topical agents were associated with increased risk of TEAEs (RR: 1.43; 95% CI: 1.14-1.79), with sofpironium associated with highest risk of dry mouth and glycopyrronium with highest risks for mydriasis and constipation.

CONCLUSIONS: Topical anticholinergic agents are effective for PAH treatment, with distinct efficacy and safety profiles. Although the available evidence is limited by the small number of trials, short follow-up durations, and heterogeneity in outcome reporting, these findings support the role of topical anticholinergic therapy as an effective non-invasive option for PAH.

PMID:41989535 | DOI:10.1007/s40261-026-01550-2

Posted on

Sustained efficacy of botulinum toxin in primary palmar hyperhidrosis: a systematic review of duration, quality of life, and satisfaction

Front Med (Lausanne). 2026 Mar 25;13:1795512. doi: 10.3389/fmed.2026.1795512. eCollection 2026.

ABSTRACT

BACKGROUND: Primary palmar hyperhidrosis (PPH) is a debilitating condition characterized by excessive sweating of the palms, significantly impairing patients’ quality of life (QoL). Botulinum toxin (BoNT) injections are a widely used treatment, but data on their sustained efficacy, impact on QoL, and patient satisfaction remain limited.

OBJECTIVE: This systematic review aimed to systematically evaluate the duration of BoNT efficacy, its effects on QoL, and patient-reported satisfaction and improvement in PPH.

METHODS: This systematic review followed PRISMA guidelines. PubMed, Cochrane Library, and Scopus databases were searched from 2005 to 2024. Studies included randomized controlled trials, observational studies, and clinical trials involving adults with PPH treated with BoNT injections. Outcomes included duration of efficacy, QoL measures (e.g., DLQI), and patient satisfaction.

RESULTS: Nineteen studies met inclusion criteria. The duration of BoNT efficacy ranged from 3 to 12 months, with BoNT-A demonstrating a mean efficacy of 4.9-9.5 months, while BoNT-B showed a shorter duration of 3.8-4.6 months. Higher doses and repeated injections were associated with prolonged symptom control. Disease severity influenced efficacy, with moderate cases experiencing longer relief compared to severe cases. QoL improvements were substantial, with Dermatology Life Quality Index (DLQI) scores showing significant reductions post-treatment. Patient satisfaction rates ranged from 65 to 100%, though this effect diminished over time.

CONCLUSION: BoNT is an effective and well-tolerated treatment for PPH, offering substantial symptom relief, improved QoL, and high patient satisfaction. Future research should focus on standardized protocols and long-term follow-up to optimize treatment strategies.

PMID:41958548 | PMC:PMC13056597 | DOI:10.3389/fmed.2026.1795512

Posted on

Oxybutynin treatment for episodic hyperhidrosis in Parkinson disease

J Parkinsons Dis. 2026 Apr 7:1877718X261440704. doi: 10.1177/1877718X261440704. Online ahead of print.

ABSTRACT

Not all medications arrive from a disciplined path of translational drug development; sometimes, the route of discovery involves serendipity. A drug developed for controlling urinary urgency, oxybutynin, is reviewed here as a highly effective treatment for excessive sweating (hyperhidrosis). Its use in Parkinson disease is described in a case report.

PMID:41944203 | DOI:10.1177/1877718X261440704