Clin Auton Res. 2026 Apr 29. doi: 10.1007/s10286-026-01202-7. Online ahead of print.
NO ABSTRACT
PMID:42053698 | DOI:10.1007/s10286-026-01202-7
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
Compensatory hyperhidrosis following microwave-based therapy for axillary hyperhidrosis
JAAD Case Rep. 2026 Mar 6;71:7-9. doi: 10.1016/j.jdcr.2026.02.046. eCollection 2026 May.
NO ABSTRACT
PMID:42005503 | PMC:PMC13087721 | DOI:10.1016/j.jdcr.2026.02.046
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
Patient-reported triggers of primary hyperhidrosis
Clin Auton Res. 2026 Apr 10. doi: 10.1007/s10286-026-01210-7. Online ahead of print.
NO ABSTRACT
PMID:41961247 | DOI:10.1007/s10286-026-01210-7
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
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
The State of Primary Hyperhidrosis: Therapeutic Advancements and National Representation
J Drugs Dermatol. 2026 Apr 1;25(4):397-398. doi: 10.36849/jdd.0426.
NO ABSTRACT
PMID:41931689 | DOI:10.36849/jdd.0426
Iodine-starch test validity in amputee patients with hyperhidrosis
Disabil Rehabil. 2026 Mar 30:1-13. doi: 10.1080/09638288.2026.2650049. Online ahead of print.
ABSTRACT
PURPOSE: Validate the iodine-starch test in amputees by comparing a novel measure, the Amputee Iodine-Starch Result (AISR) with the Hyperhidrosis Disease Severity Scale (HDSS) and to measure test-retest reliability in patients with hyperhidrosis.
MATERIALS AND METHODS: Amputee patients underwent iodine-starch testing using a previously described method. AISR was derived by visually inspecting sweat reactions on the residual limb and prosthetic sheath, scoring intensity using the Sweating Intensity Visual Scale (SIVS), measuring surface area involvement, and normalizing to residual limb surface area. Ordinal logistic regression for HDSS vs AISR was performed. Intraclass correlations (ICC) measured test-retest reliability.
RESULTS: 91 participants, including 25 control participants, underwent iodine-starch testing. The ordinal logistic regression for HDSS vs AISR on both skin (AISR-SK) (2 = 10.57, OR = 2.91 (95% CI 1.48-5.73), p = 0.0011) and sheath (AISR-SH) (2 = 8.62, OR = 2.10 (95% CI 1.26-3.51), p = 0.0033) was highly significant. ICC showed poor test-retest reliability for skin (AISR-SK, r = 0.388, ICC = 0.393, 95% CI 0.028-0.662) and sheath (AISR-SH, r = 0.194, ICC = 0.198, 95% CI -0.189, 0.526) measurements.
CONCLUSIONS: The iodine-starch test is significantly associated with HDSS, but has poor test-retest reliability.
PMID:41910115 | DOI:10.1080/09638288.2026.2650049
Advances in pharmacological treatment and management of hyperhidrosis
Expert Opin Pharmacother. 2026 Mar 23:1-10. doi: 10.1080/14656566.2026.2642213. Online ahead of print.
ABSTRACT
INTRODUCTION: Hyperhidrosis is a functional disorder characterized by excessive sweat production beyond physiological needs for thermoregulation, significantly impairing quality of life, affecting physical comfort, psychological well-being, social interactions, and work productivity.
AREAS COVERED: This review focuses on evidence-based therapeutic options for hyperhidrosis. Topical treatments (glycopyrronium bromide, glycopyrronium tosylate, aluminum salts), systemic therapy (oral oxybutynin), injectable approaches (botulinum toxin), iontophoresis, and surgical interventions (local excision, sympathectomy) are discussed in detail. Clinical studies demonstrate that topical and systemic agents are effective for localized and multisite forms, respectively, while botulinum toxin offers strong efficacy for focal hyperhidrosis. The review also addresses combination strategies, treatment tolerability, cost-effectiveness, and patient-centered approaches.
EXPERT OPINION: Managing hyperhidrosis requires a nuanced, individualized strategy that balances symptom control, safety, patient preferences, and quality of life. Combination therapies and flexible treatment sequencing can reduce early reliance on invasive procedures. Despite therapeutic advances, widespread adoption is limited by heterogeneous guidelines, off-label use, and under-recognition of psychosocial impact. Future research should focus on prospective, large-cohort studies, standardized outcome measures, and development of selective, well-tolerated therapies. While a universal cure is unlikely, sustained symptom control and meaningful improvement in quality of life represent realistic objectives.
PMID:41871366 | DOI:10.1080/14656566.2026.2642213