10 Reasons to Be Interested in Hh Research
There’s a lot of research and development going on in the world of hyperhidrosis (Hh). In fact, parts 1 and 2 of our 2021 Hyperhidrosis Research & Treatment Pipeline Report cover EIGHT developments towards better care and understanding of the management of excessive sweating. Part 1 reveals the ongoing development of Brickell Biotech’s topical gel (sofpironium bromide/BBI-4000) for the potential treatment of underarm excessive sweating. Part 2 covers hands, underarms, multifocal sweating, and four novel treatments, from Japan to the U.S.
All this is a drastic improvement compared to the dearth of investment in Hh that existed when the International Hyperhidrosis Society was formed in 2003. You’ve been with us all along, making noise, demanding action, and inspiring the search for solutions. Keep it up! It’s paying off!
In this report, you’ll find information about ten more important hyperhidrosis-related research initiatives.
Did you know that military physicians have played a role in nearly every major modern medical advancement? From the development of the first ambulance system, groundbreaking facial reconstructions, ultrasound, to even ice packs and the EpiPen, the military has helped change the way medicine is practiced. Today, the United States Department of Veterans Affairs is conducting two studies looking at residual limb hyperhidrosis among amputees with the aim of creating a research-based treatment plan for this amputation complication that leads to excessive sweating of the remaining limb, especially under a prosthetic device. Both studies are recruiting participants in Utah. Learn more and how to contact the researchers involved at:
- To establish an evidence base for a hyperhidrosis treatment algorithm in amputees
- Study of Botox to treat limb hyperhidrosis in patients with amputations
Medical scientists in France are also studying treatments for residual limb hyperhidrosis among amputees. The French research is comparing topical aluminum chloride (the ingredient in many prescription antiperspirants) with botulinum toxin A injections for the treatment of lower limb excessive sweating in the amputee population. Nine locations in France are recruiting participants, and you can find contact information here. Hyperhidrosis among amputees is a topic that’s important and yet not often talked about. The International Hyperhidrosis Society will cover the issue in more depth in an upcoming blog.
What do patient characteristics have to do with hyperhidrosis treatment? Researchers at St. Louis University are trying to find out. Approximately 200 hyperhidrosis patients have participated for more than 18 months and the study is closed. Results aren’t public, yet. It’s not clear what will come out of this study, but we are excited to find out! Measurements included: weeks until response to treatment, number of treatment changes, the percent reduction in sweat measurements, and disease impact. Stay tuned!
A company called Therapeutics, Inc. will conduct a study in the U.S. comparing the safety, tolerability, and efficacy of 1% Glycopyrronium Bromide (GPB) cream with that of Qbrexza® (Glycopyrronium) Cloth 2.4% for the treatment of primary axillary hyperhidrosis. The study is not yet recruiting participants, but a similar study is underway in Kiel, Germany. In related research looking at the use of the 1% GPB cream once daily in patients with moderate or severe primary axillary hyperhidrosis, 57% of the patients had their sweating cut in half using the GPB cream (compared to 34% using the placebo). Glycopyrronium bromide is an anticholinergic often used to treat excessive salivation or respiratory secretions, among other things. Glycopyrronium tosylate is the active ingredient in the current axillary Hh treatment Qbrexza®.
At Massachusetts General Hospital in Boston, experts are looking at the use of image-guided lasers to ablate (destroy) eccrine sweat glands (the glands that produce more watery sweat) of the palms. Learn more from this clinical trial summary. This is particularly interesting because while lasers are sometimes used to treat excessive sweating of the underarms, using lasers for palm sweating is not common. Patients involved in the study will have one palm treated with the lasers and the other not treated for easy comparison. This study is recruiting participants, and you can use this link to find contact information in Boston. In Denmark, the Zealand University Hospital is also looking at the treatment of hyperhidrosis with lasers. The Danish study, however, is focused on underarms. It’s not recruiting participants from the general public.
Meanwhile, at Stanford University, a study looking at the management of palmar hyperhidrosis with hydrogel electrode pads (rather than tap water baths) to deliver iontophoresis treatment has been completed. Results have not yet appeared in a peer-reviewed journal. As you may know, electrode pads for iontophoresis treatment of the underarms are already available. We’ll be very interested in the results of this study as they will advance understanding of whether this type of iontophoresis may be useful for the hands.
The company Merz has been investigating the use of its Ulthera System (which employs ultrasound energy) to treat underarm excessive sweating. We have seen dermatology practices offering this as an option for underarm excessive sweating treatment. This article (from 2014) and another (from 2019) indicate that the option is a safe, effective, well-tolerated, and long-lasting means for treating axillary hyperhidrosis. We’ll be reaching out to Merz to see if they intend to make this use of Ulthera more commonplace.
In Korea, researchers at a company called Medy-Tox are studying a different type of botulinum toxin type A known as MEDITOXIN as a treatment for underarm excessive sweating. Another study in Korea is focused on the use of MEDITOXIN versus Botox as a treatment for back sweating among men. Both studies are complete, and we are awaiting the publication of the results.
In Sao Paulo, Brazil, researchers are looking at the intensity of compensatory sweating after ETS surgery for palmar hyperhidrosis. Specifically, the study is comparing two different ETS techniques (“unilateral sympathectomy on the dominant side” and “bilateral sequential sympathectomy”) to see if one of them (unilateral sympathectomy on the dominant side) can obtain acceptable results with less compensatory sweating and greater improvement in quality of life. The study is recruiting in seven hospitals in Brazil.
Excessive sweating of the head and face, hands, feet, trunk, and groin (basically, everyplace except the underarms) is getting attention from the Hidrosis Clinic in Stockholm, Sweden, where researchers are studying botulinum toxin treatment for each of these body areas. The goal of these studies is to provide the medical community with randomized, double-blind, placebo-controlled data on the clinical effect and safety of botulinum toxin treatment for craniofacial, inguinal, palmar, plantar, and truncal hyperhidrosis (data that’s currently lacking.) The recruitment status for this study is unknown at the moment.
At St Joseph University in Beirut, Lebanon, researchers have been comparing two different techniques for the treatment of underarm hyperhidrosis using botulinum toxin. These are: Technique 1 - “The ‘quadrant’ technique: 5 vertical lines and 5 horizontal lines drawn on the hair-bearing area of the armpit amounting to 25 injection points with more of the points concentrated in the center. Each injection providing ~5 units of botulinum toxin. Technique 2 - “The ‘six injection’ technique: 6 injections in the hair-bearing area equally spaced with each providing ~8 units of botulinum toxin.” Results are not yet available.
A letter to the editor in the Journal of the European Academy of Dermatology and Venereology indicates that a cream containing anticholinergic oxybutynin chloride (10%) is safe and effective in treating underarm hyperhidrosis when used twice a day. Thirty patients with severe axillary excessive sweating participated in the research in Athens, Greece. Quality of life scores among those using the treatment improved by more than one-third. NO dry mouth, blurry vision, urine retention, or constipation was reported (side effects that can often be seen with anticholinergics). This potential treatment is not yet fully studied or vetted. We’ll keep an eye on it and provide more info when it’s available.
As our three-part 2021 Hyperhidrosis Research & Treatment Pipeline Report shows (find all the parts listed among our blogs), there are nearly 20 hyperhidrosis-related research initiatives going on in 8 countries around the world focusing on at least 11 different treatments (some new and some familiar options being used in new ways) for excessive sweating!
For sufferers, getting involved in research can be a potential path to treatment and a satisfying way to give back to the community that’s striving to make a difference in the excessive sweating world. And, staying abreast of what’s in the pipeline is great for fostering hope and optimism in what the future may bring. To brush up on the basics of clinical trials, click here.
For researchers and organizations conducting clinical, market, or educational research, the International Hyperhidrosis Society is here to help. Whether your project is targeted or broad, get in touch to learn how we can make the process smooth, efficient, and successful. We have deep experience in refining protocols, ensuring a patient-centric approach, and improving participation, adherence, and reliability. This, combined with our ability to make connections across the miles, across disciplines, and across the bench is central to all we do.
All of the information reported here and in our other two installments of the 2021 Hyperhidrosis Pipeline Report is publicly available. As are the results of the clinical trials published peer-reviewed medical literature – which we organize and keep up-to-date for the hyperhidrosis community here.
Hyperhidrosis awareness is so much more than just knowing what excessive sweating is and how many people are impacted by it. These basic things are SO important, of course, but getting a grasp of the nuanced research and treatment development going on out there takes awareness of the landscape to a more advanced level – showing the sophistication of you – our audience – and of the progress we’re making to continue to get this serious medical condition taken seriously by the public, healthcare providers, treatment developers, and investors.
We’re so glad you’re with us to be a part of this important work.
This report has been provided so you’re up-to-date on research underway related to hyperhidrosis. Please note that all of the information provided is publicly available, although not from one easily-digestible source. Until now! Donate to the IHhS and keep the info coming.