Anticholinergics for Hyperhidrosis

Anticholinergics are a class of medications used “off-label” to reduce the excessive sweating associated with hyperhidrosis.

Anticholinergics for Hyperhidrosis

The Skinny


Average Recovery

1 days

Permanence

Temporary

Application

Pill

Surgical

No

Cost

$500 - $1000

The Specifics


What are anticholinergics?

Anticholinergics are a class of prescription medications used 'off-label' (without approval from the United States Food and Drug Administration) in the treatment of excessive sweating due to their ability to alter cell signaling with sweat glands. Anticholinergic drugs are not usually first line treatment options due to their systemic adverse effects on the nervous system. They are typically considered in the treatment of hyperhidrosis cases refractory to antiperspirants with aluminum chloride, Botox® (botulinum toxin), iontophoresis, and other less systemic treatments.

Dermatology providers may recommend anticholinergics, like oxybutynin or glycopyrrolate (glycopyrronium). Primary hyperhidrosis, axillary hyperhidrosis (armpits), palmoplantar hyperhidrosis, and secondary hyperhidrosis can be treated with anticholinergics.

What cosmetic concerns do anticholinergics treat?

  1. Excessive Sweating: Anticholinergics generally alter peripheral cell signaling by interfering with acetylcholine communication with sweat glands.

Who is the ideal candidate for anticholinergics?

The ideal candidate for anticholinergics therapy has cranio-facial hyperhidrosis, primary focal hyperhidrosis, palmar hyperhidrosis, plantar hyperhidrosis, or those with compensatory sweating following ETS (endoscopic thoracic sympathectomy), or those with medication induced excessive sweating. Anticholinergics are not recommended for individuals over 65, those with certain chronic medical conditions, and those who are physically active such as athletes or those who work outdoors.

What is the average recovery associated with anticholinergics?

There is no recovery time associated with anticholinergics use. Patients should discuss side effects of anticholinergics medications with their provider, and remember to avoid overheating and dehydration through adequate water intake and appropriate exertion.

What are the potential side effects of anticholinergics?

Possible side effects of anticholinergic therapy include difficulty regulating body temperature, dizziness, cramping, dry mouth, urinary retention, dry eyes, weakness, nausea, headache, and dehydration.

What results can someone expect from anticholinergics?

The results of anticholinergics therapy will evolve gradually over a few weeks and require regular use to maintain results.

What is the average cost of anticholinergics?


The average cost of anticholinergics will vary by location, healthcare provider, and individual candidate needs.

Pros

Non-invasiveRelatively inexpensive

Cons

Maintenance requiredTemporary results

What to Expect


Anticholinergics are a prescription oral medication treatment used in the management of hyperhidrosis. Here is a general guide for what to expect before, during, and after anticholinergics:

The Takeaway


Anticholinergics are used in hyperhidrosis treatment when other less invasive options have not adequately improved quality of life. Oral anticholinergics reduce sweat production throughout the body. There are numerous side effects associated with their use including dry mouth and urinary retention.

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Source List

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AEDIT uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. Mayo Clinic Staff Hyperhidrosis mayoclinic.org
  2. American Academy of Dermatology Association Hyperhidrosis Diagnosis and Treatment aad.org
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