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Onabotulinum
toxin A injections
     

  Definition   Medications  

Treatment
 algorithm for

 
  Prevalence   Systemic treatment    
  Impact on quality of life   Topical treatment     Axillary and inguinal HH  

    for armpits

 >     VIDEO
  Classification   The gel Advantage     Palmoplantar HH  

    for hands

 >     VIDEO
  The Control of sweating   Needle Free Injections     Craniofacial HH  

    for feet

 >     VIDEO
Systemic Treatment of HH


Psychotherapy:


Sometimes a minor sedative that controls the stress is enough to stop the sweating. But, this measure will induce only a partial remission. Some individuals may respond better to medications like amitriptyline and hydroxyzine which have sedative or anticholinergic effect, while others respond to "Biofeedback".

Anticholinergic agents:

Sweat is activated by post-ganglionic sympathetic fibres which behave like parasympathetic or cholinergic fibres.

Solifenacin Succinate (vesicare)
Oxybutynin Hydrochloride (Ditropan) 
Glycopyrollate (Robinul, Avert)     
5 mg bid prn
5 mg tid prn
1 à 2 mg tid prn

Draw backs of anticholinergics:

Unfortunately, the anti-cholinergic effects generated by these medications are worse than the sweating itself: tachycardia, dry mouth, sluggishness of the intestinal motility, worsening of certain conditions like: glaucoma, toxic erythema, convulsions etc... Moreover, these symptoms appear long before the sweat is under control. It follows that anticholinergics have little place in the management of HH.

There are reports in the literature where cases have responded to the following medications:

Indomethacine (indocid)
Diltiazem (cardizem)
Clonidine (Catapres)
Propranolol (Inderal)
Oxprenolol (Trasicor)
25 mg tid
30 to 60 mg tid
0.1 mg BID
20 mg TID
20 mg TID

Topical treatment of HH  >>

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07/25/2012



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