A New Non-Invasive Treatment for Hyperhidrosis

Hyperhidrosis, excessive sweating, is a condition that affects about 15 million people in the US alone. While it is mostly a cosmetic concern, it has been linked to quality of life factors such as anxiety and depression. Treatment options include approaches that block sweat from reaching the skin surface, destroy sweat glands entirely, or inhibit neuronal transduction to sweat glands with great variations in treatment effectiveness, invasiveness, and side effects. Up until recently only two methods were approved by the FDA for axillary hyperhydrosis (onabotulinum toxin A and a microwave device for thermal ablation of sweat glands). In June 2018, a new treatment was approved: Glycopyrronium tosylate (GT), a topical anticholinergic that is applied once daily to the axillae by using a premoistened towelette.

A recent study described the results of clinical trials designed to assess the efficacy and safety of GT for primary axillary hyperhidrosis. The two phase 3 trials (ATMOS-1 and ATMOS-2) used the Axillary Sweating Daily Diary (ASDD), to assess severity, impact, and bothersomeness of axillary hyperhidrosis while being treated with GT or a placebo over a four-week period.

The results showed that GT treatment over 4 weeks significantly reduced severity of sweating and sweat production. Most adverse events were mild and reversible when patients stopped using the drug or reduced the frequency of application.

The conclusion was that topical, once-daily GT may provide a noninvasive, well-tolerated treatment option for primary axillary hyperhidrosis.