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  • Title: Compensatory hyperhidrosis: results of pharmacologic treatment with oxybutynin.
    Author: Teivelis MP, Wolosker N, Krutman M, Milanez de Campos JR, Kauffman P, Puech-Leão P.
    Journal: Ann Thorac Surg; 2014 Nov; 98(5):1797-802. PubMed ID: 25173719.
    Abstract:
    BACKGROUND: Hyperhidrosis may affect nearly 3% of the population, and thoracic/lumbar sympathectomy has been highly effective. Compensatory hyperhidrosis is a risk associated with surgical procedures, and its treatment is both complex and not well defined. Treatment of primary hyperhidrosis with oxybutynin has yielded positive results; however, its use in compensatory hyperhidrosis (CH) has not been described. METHODS: Twenty-one patients (11 female patients) received oxybutynin for severe CH at a median of 5 years after sympathectomy. Patients were evaluated to determine quality of life before starting oxybutynin and 6 weeks afterward; they assigned grades to determine improvement after 6 weeks and at their last consult visit for each site at which they complained of symptoms. RESULTS: Six and 15 patients underwent operation for axillary hyperhidrosis and palmar hyperhidrosis, respectively. Median follow-up time with oxybutynin was 377 days (49-1,831 days). Most common CH sites were the back (n=8) and abdomen (n=5). After 6 weeks, the quality of life improved in 71.4% of patients. Five patients stopped treatment: 2 because of unbearable dry mouth, 1 because of absence of pharmacologic response, 1 because of excessive somnolence, and 1 because of probable tachyphylaxis. At the last visit, 71.4% of patients presented with moderate to major improvement at the main sites at which sweating was noted. CONCLUSIONS: More than 70% of patients presented with improved overall quality of life and improvement at the most prominent site of compensatory sweating. Long-term treatment was ineffective in less than 25% of patients, primarily because of the side effects of dry mouth and somnolence. Oxybutynin appears to be effective in treating bothersome CH.
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