Hyperhidrosis is one of the oldest known dermatologic conditions that even today is misconceived as rare and untreatable, says John Eisenach, M.D., a Mayo Clinic anesthesiologist and the primary author of the clinical review.
"Both ancient and modern medicine have been perplexed by this entity," says Dr. Eisenach.
The description and definition of excessive sweating date back to Hippocrates in the 4th century B.C. Today, the diagnosis and treatment of severe cases command a stepwise, multidisciplinary approach from the primary care physician, the dermatologist, the neurologist, and the surgeon. Variables include the site affected, the degree of severity and the response to treatment.
Dr. Eisenach and colleagues outline their findings on the evolving therapies and how this disorder is not as rare as commonly thought. "I think we've all shaken hands with someone who is affected by this," he says. "I just hope people with this condition seek help, because of the emerging treatment options and high satisfaction rates that can be obtained, even in severe cases."
The Food and Drug Administration approval of botulinum toxin type A (Botox) has provided an effective treatment of excessive sweating, particularly for the underarms. Other treatments may be utilized for excessive sweating on the face, the palms, or soles of the feet.
A recent survey suggests that the prevalence of primary hyperhidrosis is 2.8 percent in the U.S. population, 1.4 percent have excessive sweating in the underarms (axillary hyperhidrosis), and one-sixth are projected to have sweating that is intolerable or interferes with daily activities. There also is a