Treatment of Primary Craniofacial Hyperhidrosis

Craniofacial hyperhidrosis (CH) is a facial form of focal hyperhidrosis referring to excess sweating beyond normal physiological function. The condition usually affects the forehead bilaterally but can also involve other regions of the face such as the scalp, nose, chin and cheeks less frequently. Primary CH can have debilitating effects on an individuals quality of life, and hence effective treatment is of great importance.

The condition differs from other forms of focal HH in that it presents more frequently in an older subset of patients. Before a diagnosis of CH can be made, it is important to rule out secondary causes such as the onset of menopause, diabetes mellitus, endocrine disorders or certain medications.

First line therapies for the condition include oral anticholinergics, topical glycopyrrolate, and intradermal injection therapy. These therapies are first line due to their high efficacy and favourable side effect profiles, and a sweat specialist can devise a treatment plan considering each of these options in more detail.

There is surgical management, through T2 sympathectomy, though this should be reserved for patients who are refractory to first line therapy due to the high incidence of postoperative compensatory sweating and rare, yet significant postoperative complications.

Note: Information on this site is not a substitute for professional medical advice.

References:

Treatment of Primary Craniofacial Hyperhidrosis: A Systemic Review, Nicholas et al, Am J Clin Dermatol (2015) 16:361-370