Treatment of craniofacial
hyperhidrosis currently consists of thoracic
sympathectomy, which is not widely available. Oral
anticholinergic agents and beta-blockers may be effective but also carry significant side effects. We describe a healthy, active 27-year-old male resident physician who had excessive facial sweating with minimal exertion or stress. The sweating was especially pronounced on the forehead, nose, and upper lip. Daily topical application of a 0.5%
glycopyrrolate solution to the face and forehead was offered. After the first treatment, facial sweating was significantly reduced and was well controlled under stressful situations, without any discomfort to the skin. No loss of efficacy was seen after multiple face washings. Facial
hyperhidrosis recurred after withdrawal of the
glycopyrrolate for 2 days, confirming its
therapeutic effect. Two years later, he continues to use
glycopyrrolate as needed. We conclude that topical
glycopyrrolate is effective in treating craniofacial
hyperhidrosis and is associated with few adverse effects.