👕What is hand sweating and underarm sweating (focal hyperhidrosis)?💦

Hyperhidrosis, characterized by excessive sweating in the palms and underarms, can be improved with insurance treatment.
In palmar hyperhidrosis, paper becomes soggy from sweaty hands, and in axillary hyperhidrosis, individuals worry about friends commenting on their underarm sweat, leading to restrictions in daily/social life and a reduced quality of life. The treatment goal for hyperhidrosis is not to constantly control sweating so that it never occurs in a patient's life, but rather to improve their quality of life.

Localized hyperhidrosis is diagnosed when excessive localized sweating is observed for more than 6 months without any apparent cause, and when two or more of the following diagnostic criteria are met.
1) Symptoms first appear at age 25 or younger
2) Sweating is observed symmetrically.
3) Sweating stops during sleep
4) Having episodes of hyperhidrosis at least once a week.
5) Family history is observed
6) That they interfere with daily life

💧 Items 3 and 4 below are considered indicators of severe hyperhidrosis, making topical anticholinergics an appropriate treatment. Treatment severity is classified using the Hyperhidrosis Disease Severity Scale (HDSS), which has four levels.
Sweating is not a concern at all and does not interfere with daily life.
2) Sweating is tolerable, but it sometimes interferes with daily life.
3) Sweating is almost unbearable and frequently interferes with daily life.
4) Sweating is unbearable and constantly interferes with daily life.

Anticholinergic topical medications are prescription ointments used to treat primary axillary hyperhidrosis (underarm sweating) and primary palmar hyperhidrosis (hand sweating). They are absorbed through the skin and block the substance (acetylcholine) released from the sympathetic nerves under the skin that promotes sweating, thereby suppressing excessive perspiration.
The main side effects include skin inflammation and eczema at the application site, and dry mouth. (From the above figure: Miliaria, Dyshidrosis, Hyperhidrosis - Yuichiro Oshima: Pediatric Practice, Suppl 1, 2024)

List of topical medications prescribed at our clinic for primary hyperhidrosis (insurance covered)✨