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

Abstract

Limited efficacy, costs, side-effects and complications are issues of concern for most current therapeutic modalities for focal hyperhidrosis. This study evaluated the efficacy of topical oxybutynin 10% gel in treating 61 patients with primary focal hyperhidrosis. The gel was applied to the right or left axilla, palms or soles vs. a placebo compound to the contralateral side for 30 days. A blinded visual grading of the change in starch-iodine tests was performed by 2 non-involved physicians. The Hyperhidrosis Disease Severity Scale (HDSS) and Dermatology Life Quality Index (DLQI) questionnaires were administered before and after treatment. The patients rated their satisfaction with treatment. Fifty-three patients completed the 4-week treatment. Sweat reduction in the drug-treated sweating areas was higher than in the control-treated areas. There was a significant mean improvement in pre- and post-treatment HDSS and DQLI (p = 0.001 for both). Thirty-nine subjects (74%) reported moderate-to-high satisfaction. Twice-daily topical application of oxybutynin 10% gel appears to be an effective, safe and well-tolerated treatment for focal primary hyperhidrosis.

<p>Management Strategies Of Palmar Hyperhidrosis: Challenges And Solutions</p>

“…80 The evidence to evaluate the benefits of topical oxybutynin for PH is currently insufficient; however, initial data are quite encouraging. 80,83 A recent study exploring the use of oxybutynin 10% gel in 61 patients with primary focal axillary, palmar or plantar HH reported significantly decreased sweating rates in the treated vs the control palms (mean sweat reduction 3.1 ± 0.2 vs 1.4 ± 0.3 respectively, p=0.001) in all subjects who completed 4 weeks of twice daily application (20/22). Improved Hyperhidrosis Disease Severity Scale (HDSS) and DQLI scores were also recorded in the majority of patients, with most (75%) being moderately to highly satisfied.…”

“…The medication was safe and well-tolerated. 83 Considering the effectiveness of oral oxybutynin in managing HH, an oxybutynin transdermal formulation (skin patch) was developed to control symptoms in cases of intolerance to the former. As the patch, avoiding firstpass liver metabolism, reduces the active plasma metabolites, it has been associated with fewer, yet possible adverse events.…”

Questionnaire Modifications and Alternative Scoring Methods of the Dermatology Life Quality Index: A Systematic Review

“…Out of the 55 modifications that would theoretically require permission from the copyright holders (ie, not alternative scorings), we identified 8 (14.5%) modifications for which the authors explicitly stated to have obtained permission to alter the DLQI. 25,29,[37][38][39][40][41][42] Furthermore, Professor Andrew Finlay, developer of the DLQI is a co-author in further 4 (7.3%) modifications; thus, these were carried out with his consent. 30,[43][44][45] For the rest of the modifications (k = 43, 78%), the authors did not declare if they had a permission to modify the DLQI.…”

Treatment of primary axillary hyperhidrosis with a cream formulation of oxybutynin chloride 10%

“…Assessment in focal hyperhidrosis is controversial with a significant number of patients discontinuing treatment due to lack of efficacy or adverse effects. [6][7][8][9] Our objective was to evaluate the efficacy of a different formulation, a cream of oxybutynin chloride 10% prepared as a galenic formulation.…”