Topical glycopyrrolate for patients with facial hyperhidrosis.

BACKGROUND: Facial hyperhidrosis may negatively impact the quality of life. Although various conservative modalities have been suggested, the condition is not often treated successfully.

OBJECTIVES: To examine whether topical glycopyrrolate could be an effective and safe treatment for facial hyperhidrosis.

METHODS: Twenty-five patients with facial hyperhidrosis were enrolled and treated with 2% topical glycopyrrolate on one half of the forehead while the other half of the forehead was treated with a placebo.

RESULTS: The sweat production rate of the half of the forehead treated with topical glycopyrrolate was significantly reduced to 37.6+/-2.8 mg min(-1) (mean+/-SEM) compared with 102.2+/-5.5 mg min(-1) at the placebo-treated half of the forehead (P<0.001). Patients evaluated their degree of anhidrosis as excellent in six (24%) patients, good in 16 (64%), fair in two (8%) and poor in one (4%). Twenty-four patients (96%) were partially or fully satisfied with their fair to excellent anhidrosis; only one patient (who developed a transient headache after treatment) was dissatisfied with its therapeutic effect. Only seven patients (28%) experienced recurrence within 1 day while 17 patients (68%) had recurrence within 2 days. One patient (4%) remained stable for up to 4 days.

CONCLUSIONS: Topical glycopyrrolate application appears to be effective and safe for the treatment of excessive facial sweating in primary craniofacial and secondary gustatory hyperhidrosis following sympathectomy.