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Early onset, genital, and axillary involvement are strongly associated with impaired quality of life in hyperhidrosis patients

Medicine (Baltimore). 2026 Feb 20;105(8):e47698. doi: 10.1097/MD.0000000000047698.

ABSTRACT

Hyperhidrosis is a chronic condition marked by excessive sweating that significantly affects patients’ quality of life (QoL). However, this issue is both underrecognized and undertreated, and its physical, emotional, and social burdens are often underestimated, particularly in Middle Eastern populations. A cross-sectional, analytical study was conducted across Saudi Arabia between May 2024 and April 2025. Participants were recruited through dermatology clinics and a Telegram support group. They completed an online self-administered Arabic questionnaire regarding demographics, medical history, the Arabic Hyperhidrosis Disease Severity Scale, and the Hyperhidrosis Quality of Life Index. A total of 276 Arabic-speaking adults with hyperhidrosis participated. The mean age was 27.3 years (SD ± 8.2), and 57.6% of the respondents were male. Most participants (82.9%) had severe hyperhidrosis (Hyperhidrosis Disease Severity Scale grades 3-4). The mean HidroQoL scores were 10.3 out of 14 for daily life and 16.6 out of 22 for psychosocial life, indicating moderate to severe burden. Disease severity showed the strongest association with QoL impairment (P = .001). Other factors significantly associated with daily functioning included lower education level, lower income, and sweating in the axillae and genital region, while genital involvement and low education were associated with psychosocial distress. Hyperhidrosis imposed a substantial QoL burden, especially in patients with severe symptoms and lower socioeconomic status. The findings supported the need for early detection and tailored treatment strategies and the use of culturally validated patient-reported outcome measures like the Arabic HidroQoL in clinical practice.

PMID:41731822 | DOI:10.1097/MD.0000000000047698

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Onset of Parkinson’s Disease Identified Through Hyperhidrosis: A Middle-Aged Woman Case Report

Reports (MDPI). 2026 Feb 2;9(1):50. doi: 10.3390/reports9010050.

ABSTRACT

Background and Clinical Significance: Parkinson’s disease (PD) is a neurodegenerative condition characterized by motor and non-motor symptoms, which significantly impact patients’ autonomy and quality of life levels. Basically, the PD diagnosis is clinical and, in some cases, can be challenging to diagnose due to the heterogeneity of the symptoms. Case Presentation: A 58-year-old woman who, during the COVID-19 lockdown, referred to experiences of slight tremor and stiffness in her left hand at rest, but without any other associated symptoms. Firstly, after consulting a general practitioner (GP), the patient was diagnosed with cervical radiculopathy (CR), presented as essential tremor and stiffness to the hand. Nevertheless, during the initial physiotherapy evaluation, the motor symptoms did not fully align with the diagnosis of CR. For this reason, the presence of non-motor symptoms was thoroughly investigated. Notably, hyperhidrosis was identified as a significant non-motor symptom, leading to the patient’s subsequent referral to a neurologist, who finally diagnosed PD. Conclusions: This case report highlights the essential role of physiotherapists in conducting independent assessments and comprehensive investigations of all patients’ symptoms, even when a medical diagnosis has already been established. This is particularly crucial when there is suspicion that musculoskeletal symptoms may be indicative of neurodegenerative diseases such as PD, which is well-known for its extensive array of non-motor symptoms. Especially in women with PD, non-motor symptoms tend to emerge earlier and in a more subtle manner than motor symptoms, making diagnosis challenging. Therefore, meticulous anamnestic data collection is essential, especially by physiotherapists working in direct-access settings.

PMID:41718300 | DOI:10.3390/reports9010050

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Aquagenic palmar keratoderma associated with palmoplantar hyperhidrosis: a case report

Oxf Med Case Reports. 2026 Feb 18;2026(2):omag001. doi: 10.1093/omcr/omag001. eCollection 2026 Feb.

ABSTRACT

Aquagenic palmoplantar keratoderma is a rare dermatological condition characterized by mild palmar thickening and burning pain upon exposure to water. A 31-year-old female with aquagenic keratoderma of the palms associated with palmoplantar hyperhidrosis presenting with wrinkling and hyperkeratosis within minutes of hand contact with water, resolving quickly after drying. While cystic fibrosis is a known association, most cases remain idiopathic. Treatment options such as 20% aluminum hydroxide, aluminum chloride (15%-20%), urea, salicylic acid, and botulinum toxin can be challenging, with the patient being evaluated after treatment with 16% aluminum chloride.

PMID:41716924 | PMC:PMC12916001 | DOI:10.1093/omcr/omag001

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Hospital-Based Tap Water Iontophoresis for Primary Focal Hyperhidrosis: A Real-World Analysis of Treatment Adherence, Efficacy, and Relapse

J Clin Med. 2026 Jan 13;15(2):640. doi: 10.3390/jcm15020640.

ABSTRACT

Background: Tap water iontophoresis (TWI) is a well-established second-line treatment for primary focal hyperhidrosis. While its efficacy is proven, data regarding the correlation between session frequency and clinical response, as well as long-term adherence in hospital-based settings, remain limited. Objective: We aimed to evaluate the efficacy and safety of hospital-based TWI and to analyze the relationship between the number of treatment sessions and clinical outcomes. Methods: This retrospective study included 92 patients with primary focal hyperhidrosis treated with TWI. Disease severity was assessed using the Hyperhidrosis Disease Severity Scale (HDSS). Clinical response was categorized as “Excellent” (≥2-point HDSS reduction), “Good” (1-point reduction), or “No Response.” Relapse rates and reasons for treatment discontinuation were analyzed over a 6-month follow-up period. Results: The overall objective response rate was 65.2% (46.7% Excellent, 18.5% Good). A significant positive correlation was found between the total number of treatment sessions and the degree of clinical response (r = 0.401, p < 0.001). Patients achieving an “Excellent” response completed a significantly higher median number of sessions compared to non-responders (p = 0.001). However, among responders, the relapse rate was 85% within six months. Logistical difficulties were the most common reason for treatment discontinuation (17.5%). No compensatory hyperhidrosis or severe adverse events were observed. Conclusions: Hospital-based TWI is a safe and highly effective induction therapy, with success rates closely linked to the number of completed sessions. However, the high relapse rate and logistical barriers to adherence suggest that hospital-based protocols should serve primarily as a bridge to home-based maintenance therapy to ensure sustained long-term remission.

PMID:41598578 | DOI:10.3390/jcm15020640

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A significant gap between inadequate pharmacotherapy and substantial unmet needs in palmar hyperhidrosis management in China: insights from a questionnaire-based survey among outpatients

Front Pharmacol. 2026 Jan 8;16:1715189. doi: 10.3389/fphar.2025.1715189. eCollection 2025.

ABSTRACT

BACKGROUND: Palmar hyperhidrosis, characterized by excessive sweating primarily affecting the hands, significantly impairs quality of life and psychological well-being. Although topical agents, iontophoresis, microwave therapy, and sympathectomy are established interventions, real-world treatment patterns and pharmacotherapeutic adequacy among Chinese patients remain poorly delineated.

METHODS: An anonymous, questionnaire-based survey was conducted among consecutive patients at a tertiary thoracic surgery clinic in China between March 2023 and October 2024. A total of 363 valid responses were collected and analyzed using SPSS 27.0. Descriptive statistics and multivariable logistic regression were used to evaluate treatment patterns, patient preference, and predictors of treatment selection.

RESULTS: The study cohort was composed predominantly of individuals with severe disease (87.3% HDSS grade 3-4), and nearly all participants (97.8%) presented with palmar hyperhidrosis. Regarding treatment history, only 38.1% had previously received pharmacotherapy, while 32.6% had utilized Traditional Chinese Medicine (TCM) therapeutic approaches, including TCM, acupuncture, massage and manipulation therapies. Antiperspirants (28.6%) and TCM (25.0%) were the most frequently used prior pharmacotherapies, yet both were associated with limited therapeutic efficacy. According to our survey, owing to high symptom severity, 52.9% had a general knowledge of surgical intervention before the outpatient visit. Primary concerns regarding previous pharmacotherapy included insufficient efficacy and localized adverse effects, particularly skin irritation. Notably, 50.0% of participants remained receptive to future pharmacotherapy, showing a preference for topical formulations (29.3%) and reduced dosing frequency (31.6%). Gender and disease severity were identified as significant determinants of treatment choice. Importantly, prior negative experiences – such as inefficacy and side effects – did not significantly diminish willingness to consider future pharmacologic treatment.

CONCLUSION: Inadequate management and suboptimal treatment outcomes represent considerable challenges in the care of palmar hyperhidrosis in China. Existing pharmacotherapeutic options are constrained by limited availability, inadequate efficacy, and a narrow range of approved agents – a reality that highlights a critical disconnect with substantial patient demand. These findings underscore an urgent need to accelerate drug development and clinical translation in this field.

PMID:41585901 | PMC:PMC12823788 | DOI:10.3389/fphar.2025.1715189