suggested stepwise management of primary hyperhidrosis
The following (based on published recommendations) have been suggested for management of primary hyperhidorsis
| Management steps | ||||
First | Second | Third | Fourth | Fifth | |
Axillary hyperhidrosis | topical aluminium chloride at increasing doses as tolerated | botulin A injections | systemic anticholinergic treatment at increasing doses as tolerated | iontophoresis using tap water ±topical anticholinergics | thoracoscopic sympathectomy |
Palmar hyperhidrosis
| topical aluminium chloride at increasing doses as tolerated | iontophoresis using tap water ±topical anticholinergics | systemic anticholinergic treatment at increasing doses as tolerated | thoracoscopic sympathectomy |
|
Plantar hyperhidrosis
| topical aluminium chloride at increasing doses as tolerated | iontophoresis using tap water ±topical anticholinergics | systemic anticholinergic treatment at increasing doses as tolerated |
|
|
Craniofacial hyperhidrosis
| topical aluminium chloride at increasing doses as tolerated; topical glycopyrrolate | systemic anticholinergic treatment at increasing doses as tolerated | thoracoscopic sympathectomy |
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Reference:
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