Treatment with oral oxybutynin was an effective and safe treatment for primary hyperhidrosis, according to findings from a real-world study published in Dermatologic Therapy.

This study included 30 patients from a Brazilian dermatology clinic with primary hyperhidrosis and a score of 2 or greater on the 4-point hyperhidrosis disease severity scale (HDSS). A questionnaire was used to collect demographic data, HDSS, and side effects related to oxybutynin therapy.

Patients in this real-world study were predominantly women (76.7%). The median age was 40 years, but the cohort included patients from 12 to 70 years of age. More than half (56.7%) of patients had a family history of hyperhidrosis.

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Forms of hyperhidrosis in this population included axillary (50.0%), palmoplantar (26.7%), cranio-facial (36.7%), and trunk (16.7%). The median treatment duration was 2.4 years and ranged from 1 to 6 years overall. Approximately 30% of patients received oxybutynin for 2 years, 20% received treatment for 3 years, 17% received treatment for 4 years, and 3% were treated for 6 years.

A significant improvement in the HDSS score was observed in patients during treatment (P <.001). All patients had a reduction of 1 or more degrees on the HDSS scale, which was considered a partial response. The majority of patients (66.7%) had an excellent response to therapy, as represented by 2 degrees of improvement in the HDSS. In 4 patients, there was an improvement in the HDSS by 3 levels. The mean HDSS improved from 3.87 at baseline to 1.93 after treatment.

Adverse effects were mostly mild and moderate in nature. Overall, adverse events included dry mouth (76.7%), palpitation (26.7%), dry eyes (23.3%), urinary retention (23.3%), somnolence (10.0%), constipation (6.67%), and dizziness (6.7%).

Limitations of this study were the lack of a control group or a comparison arm with other treatments and the different follow-up periods across participants.

In spite of the limitations, the investigators suggest that the real-life data indicate “that oxybutynin is effective and safe for treatment of hyperhidrosis, both in children and adults.”


Almeida ART, Ferrari F, Restrepo MVS, Rocha VB. Oxybutynin in primary hyperhidrosis: A long-term real-life study. Published online September 27, 2020. Dermatol Ther. doi:10.1111/dth.14344