Excessive sweating (hyperhidrosis) occurs in up to 3% of the population and can be seen all over the body or localized to the axilla, palms or feet (Primary focal hyperhidrosis, PFH). However, the condition can also be seen in the face or scalp area (craniofacial hyperhidrosis).
A recent study sought to characterize this issue in a cohort of post-menopausal women. Using a retrospective approach, data were obtained from medical notes of patients attending a dedicated hyperhidrosis clinic. A total of 20 female patients with postmenopausal craniofacial hyperhidrosis were identified. Their average age was 64 years and they had gone through menopause in their mid-forties. Their symptoms developed an average of 11 years after menopause.
The patients discussed the ways that hyperhidrosis affected their lives including ‘taking over my life’ or leading to a ‘major impact on quality of life.’ All 20 patients had tried oral anticholinergic agents; overall, 18 (90%) of the 20 patients had a good improvement in their symptoms on this regimen. About half tried botulinum toxin type A (BTXA) injections, and of those patients, two-thirds saw marked improvements.
The data did not provide any explanation as to what might cause this syndrome in postmenopausal women, but the authors state that postmenopausal craniofacial hyperhidrosis is a distinct subtype of PFH, which is often under recognized. Because of the adverse effects on quality of life, early recognition and treatment to find the best form of treatment is important in this cohort.