Primary hyperhidrosis typically starts in childhood and lasts until maturity. The main areas affected are the face, palms of the hands, soles of the feet, and the axilla. A patient with hyperhidrosis who started taking oxybutynin for urinary urgency is described in a case report from 1988; the patient's episodes of intense sweating stopped after a few hours. Numerous investigations conducted in recent years have confirmed its effectiveness in treating hyperhidrosis. Since it has recently been established that people with hyperhidrotic conditions have an overabundance of acetylcholine and 7-nicotinic receptors in their sympathetic ganglia, targeted treatment with oxybutynin has started to be reported. In 2003, the FDA approved oxybutynin transdermal administration for the first time in the form of a transdermal patch. The first transdermal delivery system (TDS) for oxybutynin was a patch that could be applied to the buttocks, hips, or abdomen. The transdermal patch was found to have less negative side effects and to be just as efficient in reducing the symptoms of overactive bladder when compared to oxybutynin taken orally. In the senior population, which is more likely to develop overactive bladder, transdermal distribution may also lessen the amount of pills required, memory loss, and drug-drug interactions, all of which are desired outcomes. Adults with hyperactive bladders may benefit from topically applied oxybutynin gel treatment. Oxybutynin chloride gel has been shown to be effective in treating primary focal hyperhidrosis in studies. Oxybutynin may have a longer half-life than other topical drugs like aluminium chloride, with a serum half-life of 62-84 hours following topical treatment. Patients' primary focal hyperhidrosis is treated less severely and have better health-related quality of life thanks to oxybutynin 3% gel.
Introduction: Hyperhidrosis is excessive sweating beyond thermoregulatory needs. It is a potentially disabling condition with challenging management. Aluminum chloride is the established topical treatment; however, response remains unsatisfactory. Oxybutynin is an anticholinergic drug that stands as a therapeutic chance for hyperhidrosis. Objectives: comparing the efficacy of topical oxybutynin 3% gel versus aluminum chloride 15% lotion in treatment of primary focal hyperhidrosis. Methods: Forty patients with hyperhidrosis were randomly distributed into 2 equal groups treated by either topical oxybutynin 3% gel or topical aluminum chloride 15% lotion once daily night application for 4 weeks (both groups). Evaluation was done at 2 and 4 weeks of treatment and after 1 month of the end of treatment for follow up by Minor iodine starch test, hyperhidrosis disease severity scale (HDSS) and dermatology life quality index (DLQI). Results: Both treatment modalities were effective with insignificant differences between patients of both groups regarding improvement in Minor iodine starch test and HDSS after 2 weeks of treatment (P = 0.561, 0.33 respectively). Oxybutynin 3% gel yielded significantly better improvement of Minor’s test, HDSS and patient’s quality of life at the end of 4 weeks of treatment with lower recurrence rate than aluminum chloride 15% lotion at 1 month follow up. Minimal adverse effects were noted in both studied groups. Conclusions: Oxybutynin 3% gel could be considered as a promising treatment modality for hyperhidrosis with higher efficacy than aluminum chloride 15% lotion and lower recurrence rate.
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