PSS4 - Epidemiology Of Hyperhidrosis in the United States: A Systematic Literature Review

Abstract

Hyperhidrosis is a medical condition characterized by excess sweating beyond what is physiologically required to maintain normal thermoregulation, with some evidence to suggest genetic etiology and transmission. This study assessed the epidemiology of hyperhidrosis in the US. A systematic literature search was conducted using PubMed/MEDLINE and Scopus databases and applying PICOS criteria to define scope of the search: population (patient-reported or diagnosed hyperhidrosis), outcomes (incidence, prevalence), and study type (observational). Studies conducted in the US and published in English between January 1, 2000 and January 7, 2018 were included. Epidemiological data were summarized; other included study outcomes such as population characteristics and burden of disease were reported narratively. The search yielded 897 articles eligible for title screening: 50 were retained for abstract review, of which 11 required full-text review against PICOS criteria. Five studies met all inclusion criteria, 3 of which were conducted in samples considered representative of the US population, and the remaining 2 in sub-populations (children and lower-limb amputees). Results were stratified by body area in 2 studies, with axillary hyperhidrosis being the most commonly affected (50.8%–65%). Sufferer-reported prevalence of hyperhidrosis (3 studies) ranged from 2.8% (overall US population) to 12.6% (lower-limb amputees), while diagnosed prevalence ranged from 0.10% (children) to 0.35% (US population). Over half of those surveyed indicated that sweating impacts confidence, is very embarrassing, causes anxiety, and is burdensome to cope with; however, only 38%-51% of those surveyed had discussed their symptoms with their health provider. Those asked about possible interventions for sweating felt that most interventions were not helpful or only mildly helpful. Few epidemiological studies of hyperhidrosis have been conducted. Sufferer-reported prevalence is substantially higher than diagnosed prevalence. Additional research is warranted to further understand prevalence of hyperhidrosis and increase health care provider awareness of this condition.