Hyperhidrosis Center

Skin cream controls mealtime sweating
Diabetes Forecast, Nov, 1997

Your favorite restaurant. Candlelight. You're halfway through your meal when you have to mop the sweat from your brow...and your face...and your neck...

Some people with diabetic neuropathy (nerve damage) sweat profusely after eating certain foods. This diabetic gustatory sweating can be treated with oral drugs, but these drugs often cause side effects.

Doctors in Great Britain concocted a skin cream containing the drug glycopyrrolate and found it to be effective in controlling this type of sweating.

Thirteen people who reported that their scalps, faces, and necks often sweated during or right after eating participated in the study. Ten had type 1 diabetes and three had type 2, Twelve were male. Their average age was 46.

The doctors first measured how much the people sweated before they started treatment. For this sweat challenge, each person picked a food known to make him or her sweat. (Eleven people used cheese, two used fruit.) Squares of absorbent dressing, cut to a specific size, were placed on the forehead (two places), on one arm, and on one lower leg. Twenty minutes after the person ate the food, the dressing squares were removed and weighed to see how much sweat they had absorbed.

Then each subject was given skin cream to use for two weeks. Through random assignment, some got skin cream with 0.5 percent glycopyrrolate; the others got identical-looking cream with no glycopyrrolate (the placebo cream). The subjects were told to apply the cream every other day to areas with a sweating problem, avoiding eyes, nose, and mouth, and not to wash the areas for four hours after applying the cream. Subjects used the cream for two weeks, then had another sweat challenge with the same amount of the same food as used in the first sweat challenge.

Each subject then used no cream for one week, then used the other cream for two weeks, ending with a third sweat challenge.

Throughout the five weeks of the study, subjects kept diaries. They rated how much they had sweated at each meal and snack, using a scale of 1 to 10.

When people used the glycopyrrolate cream, they had fewer episodes of sweating, and sweated less during episodes. Five people didn't sweat at all during their post-glycopyrrolate sweat challenges, whereas only one person didn't sweat during the, sweat challenge that followed two weeks on the, placebo cream. The weights of the dressing squares showed that people stayed significantly dryer during the sweat challenges after they had been using glycopyrrolate cream as opposed to when they had used placebo cream.

According to the diaries, glycopyrrolate cream reduced the frequency of sweating episodes in general by 51 percent, reduced the frequency of sweating ranked "3" or more by 84 percent, and almost completely stopped sweating episodes ranked "5" or higher.

Fourteen people originally signed up for the study, but one person withdrew after developing a rash from the glycopyrrolate cream. The 13 who completed the study reported no adverse reactions. Ten wanted to continue using glycopyrrolate after the study ended; the other three didn't feel that their sweating caused enough problems to warrant treatment.

The researchers conclude: "Topical glycopyrrolate is an acceptable, safe, and effective treatment for diabetic gustatory sweating. It can be used either on a regular basis or, as some patients expressed a preference, prior to social events. Its main limitation is in patients who have significant sweating on the scalp, as it is not possible to apply it beyond the hairline." (Diabetologia 40:299-301)

COPYRIGHT 1997 American Diabetes Association
COPYRIGHT 2004 Gale Group

Hyperhidrosis or Excessive Sweating

What is hyperhidrosis?
Where does hyperhidrosis occur?
What are the symptoms of hyperhidrosis?
What are the alternative treatments for hyperhidrosis?
Is there a surgical treatment for hyperhidrosis?