Long-term results of oxybutynin use in treating facial hyperhidrosis.
BACKGROUND
Facial hyperhidrosis can lead to serious emotional distress. Video-assisted thoracic sympathectomy resolves symptoms effectively, though it may be associated with compensatory hyperhidrosis, which may be more common in patients undergoing resection of the second thoracic ganglion. Oxybutynin has been used as a pharmacological approach to facial hyperhidrosis but the long-term results of this treatment are unclear.


OBJECTIVE
To evaluate the use of low oxybutynin doses in facial hyperhidrosis patients for at least six months.


METHODS
61 patients were monitored for over six months and assessed according to the following variables: impact of hyperhidrosis on quality of life (QOL) before treatment and after six weeks, evolution of facial hyperhidrosis after six weeks and at the last consultation, complaints of dry mouth after six weeks and on last return visit, and improvement at other hyperhidrosis sites.


RESULTS
Patients were monitored for 6 to 61 months (median=17 months). Thirty-six (59%) were female. Age ranged from 17-74 (median:45). Pre-treatment QOL was poor/very poor in 96.72%. After six weeks, 100% of patients improved QOL. Comparing results after six weeks and on the last visit, 91.8% of patients maintained the same category of improvement in facial hyperhidrosis, 3.3% worsened and 4.9% improved. Dry mouth complaints were common but not consistent throughout treatment. More than 90% of patients presented moderate/great improvement at other hyperhidrosis sites.


CONCLUSIONS
Patients who had a good initial response to treatment maintained a good response long-term, did not display tachiphylaxis and experienced improvement on other hyperhidrosis sites.
Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Nelson
N
Wolosker
Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Marcelo Passos
MP
Teivelis
Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Mariana
M
Krutman
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Taiz Pereira Dozono de Almeida
TP
Campbell
Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Paulo
P
Kauffman
Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
José Ribas de
JR
Campos
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Pedro
P
Puech-Leão
D000293:Adolescent; D000328:Adult; D000368:Aged; D005145:Face; D005260:Female; D006801:Humans; D006945:Hyperhidrosis / Q000188:drug therapy*; D008297:Male; D008333:Mandelic Acids / Q000008:administration & dosage*; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000008:administration & dosage*; D011788:Quality of Life; D013997:Time Factors; D016896:Treatment Outcome; D014987:Xerostomia / Q000139:chemically induced; D055815:Young Adult
D008333:Mandelic Acids; D018727:Muscarinic Antagonists; C005419:oxybutynin