title: Treatment of compensatory gustatory hyperhidrosis with topical glycopyrrolate.
abstract: Gustatory hyperhidrosis is facial sweating usually associated with the eating of hot spicy food or even smelling this food. Current options of treatment include oral anticholinergic drugs, the topical application of anticholinergics or aluminum chloride, and the injection of botulinum toxin. Thirteen patients have been treated to date with 1.5% or 2% topical glycopyrrolate. All patients had gustatory hyperhidrosis, which interfered with their social activities, after transthroacic endoscopic sympathectomy, and which was associated with compensatory focal hyperhidrosis. After applying topical glycopyrrolate, the subjective effect was excellent (no sweating after eating hot spicy food) in 10 patients (77%), and fair (clearly reduced sweating) in 3 patients (23%). All had reported incidents of being very embarrassed whilst eating hot spicy foods. Adverse effects included a mildly dry mouth and a sore throat in 2 patients (2% glycopyrrolate), a light headache in 1 patient (1.5% glycopyrrolate). The topical application of a glycopyrrolate pad appeared to be safe, efficacious, well tolerated, and a convenient method of treatment for moderate to severe symptoms of gustatory hyperhidrosis in post transthoracic endoscopic sympathectomy or sympathicotomy patients, with few side effects.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, Korea. wokim@yumc.yonsei.ac.kr
authors.forename: Won-Oak
authors.initials: WO
authors.lastname: Kim
authors.forename: Hae-Keum
authors.initials: HK
authors.lastname: Kil
authors.forename: Duck-Me
authors.initials: DM
authors.lastname: Yoon
authors.forename: Min-Jeong
authors.initials: MJ
authors.lastname: Cho
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D018680:Cholinergic Antagonists / Q000008:administration & dosage*; D004724:Endoscopy / Q000009:adverse effects; D005260:Female; D006024:Glycopyrrolate / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D013547:Sweating, Gustatory / Q000188:drug therapy* / Q000209:etiology; D013562:Sympathectomy / Q000009:adverse effects / Q000379:methods
chemical_list: D018680:Cholinergic Antagonists; D006024:Glycopyrrolate