Abstract
Hyperhidrosis (HH) is characterized by sweating exceeding the amount necessary to meet the thermal regulation and physiological needs of the body. Approximately 9.41% of individuals with HH have craniofacial hyperhidrosis (FH). The present study aims to review the most current data in the literature regarding craniofacial hyperhidrosis, including pathophysiology, diagnosis and clinical presentation, treatment options (clinical and surgical), and outcomes. VATS (videothoracoscopy sympathectomy) is considered the gold standard for definitive treatment of axillary or palmar hyperhidrosis. Recently, several studies have shown the usefulness of clinical treatment with oxybutynin hydrochloride, leading to clinical improvement of HH in more than 70% of users. Both clinical and surgical treatment of craniofacial hyperhidrosis have good results. However, surgical treatment of FH is associated with more complications. Clinical treatment with oxybutynin hydrochloride yields good results and can be the first therapeutic option. When the patient is not satisfied with this treatment and has good clinical conditions, surgical treatment can be used safely.
Highlights
In a very stressful society, sweating increases as a direct adrenergic response to the sympathetic nervous system and has become a frequent complaint in our daily medical practice.[1]Hyperhidrosis (HH) is defined as sweating exceeding the necessary amount to meet the body’s thermal regulation and physiological needs
We have 20 years of experience with hyperhidrosis and have followed-up more than 2,400 patients treated with VATS and 1,500 patients treated with oral oxybutynin.[2,6]
Over the last ten years, we have conducted several studies showing the usefulness and safety of treatment with oxybutynin hydrochloride, an anticholinergic, that leads to clinical improvement of HH in more than 70% of users.[16]
Summary
Nelson Wolosker[1,2], Carolina Brito Faustino[1 ], Marcelo Fiorelli Alexandrino da Silva[1 ], José Ribas Milanez de Campos[1,3], Paulo Kauffman[1,2]
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