The disease known as hyperhidrosis—a chronic skin condition known to cause excessive sweating—can result in significant psychological, physical, and economic burden for patients’ daily lives across several different regions, according to new findings, and its prevalence varies substantially across different populations.¹

This information resulted from a recent literature review designed to examine both the epidemiology and burden of this skin condition across several countries, given known effects of the condition and the necessity for patients to receive long-lasting treatment with aluminum chloride and/or antiperspirants.²

To learn more, the research was conducted by a team of investigators and authored by Akihiko Ikoma, MD, PhD, from Maruho Co., Ltd., in Osaka, Japan.

“Little is known about the epidemiology and burden of hyperhidrosis across regions to date,” Ikoma and colleagues wrote. “Therefore, the objective of the project was to gather current evidence on the burden of hyperhidrosis by conducting targeted literature reviews (TLR) on epidemiology, and the human and economic burden posed on patients with this condition.”

Background and Findings

The investigators used a targeted literature review (TLR) which they conducted through Ovid MEDLINE(R), Medline, and ICHUSHI database searches, with the ICHUSHI being included due to the study's focus on Japan. The TLRs aimed at epidemiology and human burden in East Asian countries (China, Korea, Taiwan, Japan), the US, and Europe (Germany, France, Spain, Italy, and the UK), though for the economic burden assessment, no geographical restrictions were used.

To be used in the investigators’ TLRs, publications between January of 2000 and September of 2020 were selected, with an analysis of 50 patients minimum being required. The inclusion and exclusion criteria were meticulously applied thanks to an experienced analyst who ended up screening the titles and abstracts to determine which would be the relevant articles.

For articles meeting the inclusion criteria or needing further examination, the full text was reviewed by the research team. The investigators’ assessed outcomes included Health-Related Quality of Life (HRQoL), incidence, prevalence, treatment adherence/compliance, Patient-Reported Outcomes (PROs), and patient satisfaction.

The conversion rate of Japanese Yen (JPY) to United States Dollars (USD) which the team used was noted as being 1 USD = 130 JPY as of March 7, 2023.

Overall, out of the 64 publications initially found by the investigators, 38 publications were carefully decided upon to contribute to the team’s literature review. The incidence of hyperhidrosis was found to have exhibited variations from 0.13% in the UK to 0.28% in the USA, with a higher occurrence being seen among females.

Likewise, the investigators reported that hyperhidrosis’s prevalence ranged from 2.8% – 4.8% for the US population to 18.40% for Chinese inpatients, whereas the ‘axillary’ hyperhidrosis’s prevalence fluctuated from 1.4% for the US population to 5.75% for Japanese employees and/or students.

The research team noted that hyperhidrosis substantially hindered reported work performance for US individuals, with the team adding that 33.5% expressed dissatisfaction as a result of excessive sweating. The team reported that post-treatment, patients showed high satisfaction levels.

The condition’s treatment using botulinum toxin and surgery incurred considerable costs for the patients, and surgery necessitated hospital stays which lasted from 10 hours - 3 days. The investigators found that the percentage of those seeking medical consultation varied, being 6.3% for Japanese patients with primary focal hyperhidrosis and 51% for the US population with any form of hyperhidrosis.

While limited evidence exists on the hyperhidrosis burden, particularly among those in Japan, it still was shown to be a substantial hindrance to patients' overall daily functioning.

“Despite limited data, available evidence suggests that hyperhidrosis places physical, psychological, and economic burdens on the daily lives of individual patients,” they wrote. “The introduction of new treatments is expected to improve the medical environment of hyperhidrosis and reduce the burden on patients.”

To address this skin condition, the investigators note that future actions may need to involve implementation of educational programs to conduct larger studies, raise awareness, and generate more evidence. Understanding both the nature and impact of hyperhidrosis is of highest importance in addressing its challenges.

References

1. ^{Oshima, Y, Fujimoto, T, Nomoto, M, Fukui, J, Ikoma, A. Hyperhidrosis: A targeted literature review of the disease burden. J Dermatol. 2023; 00: 1–10. https://doi.org/10.1111/1346-8138.16908.}
2. ^{McConaghy JRFD. Hyperhidrosis: management options. Am Fam Physician. 2018; 97: 729– 734.}