title: Topical glycopyrrolate reduces axillary hyperhidrosis.
abstract: BACKGROUND
  Oral anti-cholinergic medications reduce generalized hyperhidrosis, but the effectiveness of topical anticholinergic solutions on axillary hyperhidrosis is unclear. This study determines the initial effectiveness of 1% and 2% topical glycopyrrolate spray and compares this with Botulinum toxin type A injections for the management of axillary hyperhidrosis.
  
  
  METHODS
  In a non-randomized, consecutive patient, prospective questionnaire, treatment comparison study, 40 patients with axillary hyperhidrosis were allocated to one of four study groups (10 patients to each group): (a) 1% glycopyrrolate spray, (b) 2% glycopyrrolate spray, (c) subcutaneous Botulinum toxin type A injections, (d) no treatment. Clinical outcomes were measured by comparing a prospectively administered questionnaire, completed both pre-treatment and 6 weeks after starting treatment. Forty healthy volunteers without axillary hyperhidrosis completed the same questionnaire.
  
  
  RESULTS
  The three treatment groups showed a significant (P < 0.05) improvement in their hyperhidrosis scores following treatment. The degree of improvement was less for the 1% glycopyrrolate group when compared with the Botulinum toxin type A group (P < 0.05), but there was no difference in treatment outcomes between the 2% glycopyrrolate and Botulinum toxin type A groups. No treatment group experienced reduced hyperhidrosis to a level similar to those without hyperhidrosis. Patients in both, the 2% glycopyrrolate and Botulinum toxin type A groups reported a significant improvement in axillary hyperhidrosis symptoms. These included reduction in psychologically precipitating factors (e.g. public speaking) and axillary hyperhidrosis-specific physical effects (e.g. limitation of clothing choice).
  
  
  CONCLUSIONS
  Topical glycopyrrolate spray could provide a further treatment modality to manage axillary hyperhidrosis.
authors.affiliation: Department of Surgery, Royal Free Hospital, London, UK.
authors.forename: D M
authors.initials: DM
authors.lastname: Baker
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001365:Axilla; D005260:Female; D006024:Glycopyrrolate / Q000627:therapeutic use*; D006801:Humans; D006945:Hyperhidrosis / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged
chemical_list: D006024:Glycopyrrolate