Quality of Life and Social Isolation in Greek Adolescents with Primary Focal Hyperhidrosis Treated with Botulinum Toxin Type A: A Case Series

Abstract

Primary hyperhidrosis, although extensively documented in adults, typically has onset that dates back to early childhood. It is an unpleasant and socially disabling problem for the affected child, but little attention has been paid to the disease in adolescents. The objective of the current study was to evaluate the effectiveness of botulinum toxin type A (BTXA) in adolescents with primary palmar and axillary hyperhidrosis and to determine its effect on quality of life and social isolation. Thirty-five individuals (17 girls, 18 boys) with moderate to severe palmar and axillary hyperhidrosis were treated with BTXA (onabotulinum). Patients were examined at baseline and 6 months after treatment. The Hyperhidrosis Disease Severity Scale (HDSS) was used to evaluate disease severity and the Children's Dermatology Life Quality Index (CDLQI) was used to assess quality of life. The University of California at Los Angeles loneliness scale (UCLA version 3) was used to assess personal perception of loneliness and social isolation. The median age of the participants was 14 years, and 48.6% were female. Twenty-one had palmar hyperhidrosis, and 14 had axillary hyperhidrosis. Total CDLQI and social isolation scores decreased significantly after treatment with BTXA (both p < 0.001). There was a significant difference between pre- and post-treatment levels of severity of hyperhidrosis. No statistically significant difference was documented for CDLQI and UCLA scores between boys and girls. Treatment of hyperhidrosis with BTXA resulted in improvement in quality of life, social skills, and activities.

Topical Oxybutynin 10% Gel for the Treatment of Primary Focal Hyperhidrosis: A Randomized Double-blind Placebo-controlled Split Area Study

“…Hyperhidrosis is defined as excessive sweating beyond normal thermoregulatory needs and environmental conditions. It is a relatively common disorder, with a prevalence of 3% in the US (1), and one that significantly impairs the affected individual's quality of life (2,3). Treatment of primary focal hyperhidrosis remains challenging.…”

“…Ofir ARTZI 1 , Christophoros LOIZIDES 1 , Eyal ZUR 2 and Eli SPRECHER 1,3 1 Department of Dermatology, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 2 Central Compounding Laboratory, Petach-Tikva, and 3 Department of Human Molecular Genetics & Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel…”

“…The patients were interviewed twice; first at the time of screening before the initial application and then following completion of the 30 th day of treatment. They were asked to rate the severity of their condition using the Hyperhidrosis Disease Severity Scale (HDSS) (2,17) in which a score of 3 or 4 indicates severe hyperhidrosis, while a score of 1 or 2 indicates mild or moderate hyperhidrosis. The therapeutic results were considered as "excellent" or "good" if the patient indicated a reduction of 2 or 1 points, respectively, on the HDSS score.…”

“…H yperhidrosis is a common condition, affecting up to 3% of the population, and has a significant impact on many aspects of the affected individual's life (1)(2)(3). Primary hyperhidrosis manifests mainly in the axillae, palms, soles and facial regions (3).…”

Hyperhidrosis Substantially Reduces Quality of Life in Children: A Retrospective Study Describing Symptoms, Consequences and Treatment with Botulinum Toxin

“…Quality of life (QoL), measured with the Dermatology Life Quality Index (DLQI), is severely affected in adults with hyperhidrosis, with results comparable to the most severely affected patients with psoriasis and isotretinoin-treated acne (2). Many elderly people with hyperhidrosis remember their childhood and youth as a troublesome period with respect to the disease, but there is little reference in the literature to QoL in children with hyperhidrosis (4,5).…”