What is the best drug to treat primary facial hyperhidrosis (excessive sweating) and what is the recommended dosage per day?

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From the Research

For primary facial hyperhidrosis, topical glycopyrrolate 2% is the most effective and recommended treatment, with a faster onset of action and comparable results to Botulinum toxin A, as shown in the most recent study 1. The treatment of primary facial hyperhidrosis aims to reduce excessive sweating and improve the patient's quality of life.

  • The most recent study 1 compared the efficacy and safety of topical 2% glycopyrrolate and intradermal Botulinum toxin A injection in 24 patients with primary facial hyperhidrosis.
  • The results showed that both treatments had a complete response in 75% of cases, with a longer duration of action in the Botulinum toxin group, but topical glycopyrrolate had a faster onset of action.
  • The Hyperhidrosis Disease Severity Scale and Dermatology Life Quality Index (DLQI) showed statistically significant improvement after treatment with both modalities.
  • Topical glycopyrrolate 2% is a recommended treatment option for primary facial hyperhidrosis, with a faster onset of action and fewer systemic side effects compared to oral anticholinergic medications.
  • The dosage of topical glycopyrrolate 2% can be applied as needed, with a recommended frequency of application to achieve optimal results.
  • Other treatment options, such as oral anticholinergic medications, including glycopyrrolate and oxybutynin, may be considered if topical treatments are not effective or tolerated, as suggested in earlier studies 2, 3, 4, 5.

References

Research

Intradermal Botulinum Toxin A Injection Versus Topical 2% Glycopyrrolate for the Treatment of Primary Facial Hyperhidrosis: A Pilot Study and Review of Literature.

Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], 2022

Research

Hyperhidrosis: Management Options.

American family physician, 2018

Research

Treatment options for hyperhidrosis.

American journal of clinical dermatology, 2011

Research

Topical glycopyrrolate for patients with facial hyperhidrosis.

The British journal of dermatology, 2008

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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