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Live Blog: Novel Approaches to Treating Hyperhidrosis​. Faculty: David Pariser, MD

In this live blog from the Annual Fall SDPA Conference in Orlando, FL, David Pariser, MD gave a lecture called “Novel Approaches to Treating Hyperhidrosis.” Here are some of the highlights.

Dr. Pariser began his lecture with a hypothetical case study.

“A 54-year old man has a job which exposes him to the public.  He frequently gives public speeches and within a few minutes notices sweat rings appearing on his shirt under his arms.  No matter how he tries to hide it, the sweating gets worse. Once the sweat went all the way down the sleeve of his shirt. He feels that the problem has been an impediment to his career advancement.​”

Dr. Pariser then clicked to a picture of President Obama sweating heavily while giving a speech.

All joking aside, Dr. Pariser emphasized that hyperhidrosis – which is defined as sweating more than is required to maintain normal thermal regulation – is a serious condition associated with substantial psychological and social burden that interferes with quality of life. In fact, people who suffer from palmar hyperhidrosis report even lower quality of life issues than people who suffer from severe plaque psoriasis.

Hyperhidrosis may be primary or secondary. Primary disease is typically idiopathic, focal, excessive, bilateral, symmetrical sweating that involved in one or more of the following areas: axillae, palms, feet or face. Secondary hyperhidrosis is usually generalized and may be linked to an underlying condition or pharmacologic effect.

Hyperhidrosis is much more prevalent than you may expect. Approximately 2.8% of the population in the United States suffer from the disease (about 7.8 million people). That is about the same amount of people who suffer from psoriasis. About 93% of hyperhidrosis sufferers indicate that the condition interferes with daily life at least part of the time, with 1.3 million people reporting that their hyperhidrosis  is barely tolerable or intolerable.

Dr. Pariser touched on a number of treatment options for hyperhidrosis, including non-invasive (topical antiperspirants, systemic medications), minimally invasive (botox injections, microwave thermolysis), and surgical treatments. One of the treatments that Dr. Pariser focused on was botox injections.

Botox is minimally invasive compared to local surgery and it is approved in the US, UK, EU, and Canada for hyperhidrosis treatment. Dr. Pariser noted that botox injections are highly effective, with long duration of effects. That they produce a high level of patient satisfaction and significantly improves quality of life. However, the disadvantage of botox injections is that they require multiple injections repeated over time.

In conclusion, Dr. Pariser emphasized that more healthcare providers should familiarize themselves with the condition and treatments available to patients suffering from hyperhidrosis. Treatment options can be easily learned, easily integrated into routine office practice and is an ideal procedure for non-physician healthcare providers to perform. Finally, treatment of hyperhidrosis can lead to a greater improvement of patients quality of life than treatment of any other dermatologic disorder.


Image: Jeff Power

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