Featuring guest faculty, Adam Friedman, MD
For the lunch time product theater, Dr. Adam Friedman presented a conversation on primary hyperhidrosis and treatment with Qbrexza. Qbrexza is the first and only FDA approved once daily topical anticholinergic cloth towelette indicated for the treatment of primary axillary hyperhidrosis in people 9 years of age and older. Primary hyperhidrosis is idiopathic excessive sweating. Primary hyperhidrosis typically presents prior to the age of 25 years. Patients with primary hyperhidrosis will commonly have a family history and it is common for patients to report their sweating stops at night. Patients with primary hyperhidrosis tend to sweat up to four times more than what is needed for body temperature regulation.
While it is estimated that 10 million individuals in the US suffer from hyperhidrosis, a large percentage of patients do not seek treatment. Dr. Friedman brought a patient with him to discuss her experience and she reported that she was embarrassed by her condition and was unaware it was a medical condition. Dr. Friedman echoed that more than any other condition he treats, the majority of patients he has helped with this condition are relieved when they find out they have a “medical problem” which makes getting the diagnosis right very important.
While it is estimated that 10 million individuals in the US suffer from hyperhidrosis, a large percentage of patients do not seek treatment.
The pathophysiology of hyperhidrosis involves overstimulation of the sweat glands through excessive cholinergic activity. Qbrexza works by blocking the anticholinergic receptor. Qbrexza is contraindicated in patients with glaucoma, unstable cardiovascular status, severe ulcerative colitis, toxic megacolon, myasthenia gravis, Sjogren’s syndrome and paralytic ileus. Additionally, it should be used with caution in patients who take other anticholinergics. The most common side effect of Qbrexza is dry mouth. Additionally, since there is no safety data available of use in pregnancy, it is not recommended to be used in pregnancy or during lactation. For patients who use Qbrexza, it is imperative these patients are educated on proper use of this medication.
Dr. Friedman and the patient reiterated the importance of education of hyperhidrosis for patients to help with the embarrassment patients feel about this condition. As mentioned previously, many patients aren’t even aware that hyperhidrosis is a medical condition and it may be easier if providers start the conversation with a patient if they observe signs of this condition. Qbrexza is considered as effective as antiperspirants, which was the previously first line therapy of hyperhidrosis.