From the Research
Pediatric hyperhidrosis can be effectively managed through a stepwise approach, starting with aluminum chloride-based antiperspirants, followed by oral anticholinergics like glycopyrrolate, and then considering iontophoresis or botulinum toxin injections for severe cases. The treatment of pediatric hyperhidrosis should prioritize minimizing morbidity, mortality, and improving quality of life. According to the study by 1, oral glycopyrrolate has been shown to be safe and effective in children with hyperhidrosis, with 92% of patients noting improvement and 75% recommending the treatment to others.
Treatment Options
- Aluminum chloride-based antiperspirants like Drysol (20% solution) applied nightly to dry skin, then covered with plastic wrap overnight, can be an effective first-line treatment.
- Oral anticholinergics such as glycopyrrolate (1-2mg daily) can be considered for children who don't respond to topical treatments, although side effects like dry mouth and constipation should be monitored.
- Iontophoresis, which uses a mild electrical current through water to temporarily block sweat glands, is another option for hands and feet, typically administered in 20-30 minute sessions several times weekly initially, then maintenance sessions as needed.
- For severe cases unresponsive to these treatments, botulinum toxin injections may be considered in adolescents, providing 4-6 months of relief, as shown in the study by 2.
Practical Measures
- Wearing moisture-wicking clothing can help keep the skin dry and reduce sweating.
- Using absorbent powders can help absorb excess moisture and reduce friction.
- Avoiding triggers like spicy foods and stress can also help reduce sweating.
- Hyperhidrosis often improves with age, and treatment should be accompanied by these practical measures to improve quality of life. The study by 3 provides a comprehensive review of treatment options for hyperhidrosis, including topical medications, iontophoresis, botulinum toxin injections, systemic medications, and surgery. However, the most recent and highest quality study on pediatric hyperhidrosis is 1, which supports the use of oral glycopyrrolate as a safe and effective treatment option.