Treatment of compensatory gustatory hyperhidrosis with topical glycopyrrolate.
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.
Kim
Won-Oak
WO
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
Kil
Hae-Keum
HK
Yoon
Duck-Me
DM
Cho
Min-Jeong
MJ
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
D018680:Cholinergic Antagonists; D006024:Glycopyrrolate