General Dermatology

Oxybutynin Effectively Reduces Severity of Primary Hyperhidrosis, Real-World Study Suggests

Avatar photoBrandon May
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Women are at higher risk of hyperthyroidism than men, although both sexes can be affected, with risk greatest in patients with a family history of Graves disease or other thyroid disorders.7 In patients with hyperthyroidism, epidermal thinning is the most commonly reported skin manifestation.8 Other skin anomalies include softness, excessive perspiration (ie, hyperhidrosis; pictured), and warmth, causing skin to feel like that of an infant.3 Itching, generalized pruritus, chronic urticaria, vitiligo, and diffuse skin pigmentation have also been reported.8 Dermal changes most commonly result from autoimmunity, rather than from hormones directly affecting the skin.3
Women are at higher risk of hyperthyroidism than men, although both sexes can be affected, with risk greatest in patients with a family history of Graves disease or other thyroid disorders.7 In patients with hyperthyroidism, epidermal thinning is the most commonly reported skin manifestation.8 Other skin anomalies include softness, excessive perspiration (ie, hyperhidrosis; pictured), and warmth, causing skin to feel like that of an infant.3 Itching, generalized pruritus, chronic urticaria, vitiligo, and diffuse skin pigmentation have also been reported.8 Dermal changes most commonly result from autoimmunity, rather than from hormones directly affecting the skin.3
The effectiveness of oral oxybutynin in hyperhidrosis, besides its tolerance and safety, was evaluated in a real-life study.

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.

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.

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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.”

Reference

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

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