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Patients With Palmar Hyperhidrosis Not Sweating Over Quality of Life With Oxybutynin


Researchers assessed the effectiveness of oxybutynin in the gel and nanoemulgel forms and found both reduced scores on the Hyperhidrosis Disease Severity Scale.

Oxybutynin gel and oxybutynin nanoemulgel provided similar efficacy in decreasing disease severity and improving quality of life in patients with palmar hyperhidrosis.1 The double-blind, controlled, randomized pilot study included 30 patients over 18 years of age diagnosed with primary palmar hyperhidrosis.



Participants were divided into 2 groups of 15, with 1 group applying 1% oxybutynin topical gel and the other 1% oxybutynin topical nanoemulgel. For 1 month, patients applied approximately .25 g of the assigned product to each palm every 12 hours. Participants were given the Hyperhidrosis Disease Severity Scale (HDSS), Visual Analog Scale (VAS), and Dermatology Life Quality Index (DLQI) at baseline and after 1 month of treatment.

Participants were shown how to apply the gel from the 15 g tube labeled A or B, depending on product. Groups were similar based on sex and age, with the mean age being 28.86 ± 8.48.

Outcomes from the HDSS, VAS, and DLQI assessments were similar (P > .05) between groups at the beginning and end of the study. The HDSS score fell significantly in both the gel and the nanoemulgel groups from the beginning to the end of the study. The mean score on the VAS also decreased significantly in both groups. Both products also significantly improved patients’ quality of life as assessed on the DLQI.

The 2 groups did not experience significantly different adverse events (AEs). Dry mouth was experienced transiently during the first week of treatment by 3 patients in the nanoemulgel group and 2 in the gel group. In the gel group, 1 patient experienced urinary retention in the first days of treatment. All AEs went away within a few days without intervention.

The use of anticholinergic drugs is effective in treating palmar hyperhidrosis, but can cause significant AEs such as xerostomia, blurred vision, hyperthermia, gastrointestinal issues, and more. By using topical anticholinergics many of these AEs can be avoided.

Nanoemulgels increase bioavailability of the drug and reduce the amount of product required for effective treatment. Due to the higher cost of the oxybutynin nanoemulgel but similar effectiveness to the oxybutynin gel, though, authors recommend using the simple gel product.


  1. Saki N, Shakouri N, Rastaghi F, Hosseini SA, Alipour S, Ahramiyanpour, N. Oxybutynin gel versus nanoemulgel for treating primary palmar hyperhidrosis: A pilot double-blind randomized controlled trial. J Cosmet Dermatol. 2023;22:2268-2272. doi:10.1111/jocd.15715
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