Oxybutynin and its relative efficacy as the leading treatment for hyperhidrosis

Oxybutynin is an anticholinergic medication that is U.S. Food and Drug Administration (FDA) approved for individuals ages five and older for urinary urge incontinence and frequency; its success is also attributable to its’ spasmolytic properties. Its effects are primarily impactful on the detrusor muscle, a smooth muscle whose overactivity results in a hyperactive bladder. Oxybutynin functions as a competitive inhibitor of acetylcholine in postganglionic muscarinic receptors, thereby relaxing the detrusor muscle. Oxybutynin has several adverse effects related to its anticholinergic properties, which include headache, constipation, dry eyes, and hypohydrosis. Over the last three decades, the medication has been growing in popularity for its off-label use in the treatment of primary or idiopathic hyperhidrosis, a condition that affects an estimated 3% of the general population and typically begins to present in childhood and remains a lifelong condition. This paper aims to assess Oxybutynin’s posed efficacy compared to other novel therapies primarily based on Dermatology Life Quality Index (DLQI) patient scores and a holistic approach that considers invasiveness and risks posed by other techniques. Thirteen studies with quantitative data were analyzed and 38 were referenced in total for holistic consideration of current treatments. These comparative treatments include Botulinum Toxin A, the selective removal of eccrine sweat glands, Endoscopic Thoracoscopic Sympathectomy (ETS), and Glycopyrrolate. We contend that Oxybutynin remains the best first-line choice for the treatment of Hyperhidrosis, given its relatively high DLQI scores, non-invasiveness, low-risk side effects, cost-effectiveness, and consistent and continued efficacy with daily use.