chronic

Primary Focal Hyperhidrosis

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources2 sources

International Hyperhidrosis Society Guidelines 2019 · Anhydrol Forte 20% w/v cutaneous solution SmPC sections 4.1-4.4 (eMC product 3749)

Verified against3 documents

Anhydrol Forte 20% w/v cutaneous solution SmPC sections 4.1-4.4 (eMC product 3749)
International Hyperhidrosis Society Guidelines 2019
Primary Focal Hyperhidrosis - disease-level clinical article (hyperhidrosis-clinical.txt)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (7)

Excess sweating is reported in areas dense with sweat glands - palms, soles, face, scalp, or armpits [sweating]
Primary disease tends to affect younger patients, those with symptoms over 6 months, a family history, and bilateral involvement
Onset after midlife should raise concern for a secondary cause rather than primary disease
By definition, primary disease spares sleep - sweating decreases or stops at night [sweating]
Diagnostic criteria require symmetric sweating on both sides of the body [sweating]
Episodes of excess sweating last at least 7 days at a time under the diagnostic criteria [sweating]
The formal criteria restrict primary disease to onset at age 25 or younger

Tests (4)

When a secondary cause is suspected, work-up includes a complete blood count, basic metabolic panel, TSH, ESR, ANA, HbA1c, and chest x-ray
These tests screen for infection, kidney problems, cancer, diabetes, thyroid disease, or a connective tissue disorder as causes of secondary sweating
A measuring scale can grade how much of the palm is affected, or a starch-iodine test can map the pattern
Visual assessment alone is usually sufficient to diagnose, so these scoring tools are not widely used in practice

If not this — what else fits (3)

Thyroid overactivity, a peripheral nerve disorder, or low blood sugar episodes are also on the differential
An adrenal catecholamine-secreting tumor, the menopausal transition, or an underlying lymphoma should also be considered
Active tuberculosis or alcohol dependence are also listed as possible causes

SourceStatPearls "Hyperhidrosis" - disease-level clinical article

Presentation findings are traced to the source above.

ALUMINIUM CHLORIDE

1st line

Formtopical

Adult dose and duration

Apply 20% solution to clean, completely dry skin once daily at bedtime until sweating is controlled, then reduce frequency; wash off in morning x 1-2 weeks nightly initiation, then 1-2 times weekly maintenance

Paediatric dose

Dose by age
Children >=12 years:	apply sparingly at night

Dose source

Anhydrol Forte 20% w/v cutaneous solution SmPC sections 4.1-4.4 (eMC product 3749)

Why

Topical aluminium chloride hexahydrate solution acts as first-line antiperspirant/astringent barrier; available as standalone 20% preparation in Egypt.

Cautions

Apply only to completely dry skin to minimize skin irritation and burning.
Do not apply to broken, inflamed, or recently shaved skin.
Wash off thoroughly in the morning; may stain clothing.
Wash it off in the morning - it is not left on through the day.
No shaving and no depilatory within 12 hours either side of an application to the armpits, and do not bathe just before applying. Broken or freshly shaved skin is what turns this into a burn, and the burn is why people give up on a treatment that works.

Egyptian brands

Egyptian brand	Manufacturer	Indicative price
ABC MOCOTIVE TOPICAL SPRAY 70 ML! also contains alcohol, chamomile, glycerin, tea tree oil, vit.e	> EGYSTAR PHARM	30.00 EGP

REFERRAL & SAFETY-NETTING (NO DRUG THERAPY)

1st line

Dose source

Hyperhidrosis - disease-level clinical article (hyperhidrosis-clinical.txt)

Why

Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.

Cautions

RED FLAG - Work up and exclude secondary causes of hyperhidrosis (infection, malignancy, thyroid disease, diabetes mellitus).

GLYCOPYRRONIUM

2nd line

Strength1 mg

Formoral.solid

Adult dose and duration

1-2 mg 1-2 times daily on an empty stomach - long-term under monitoring

Paediatric dose

Specialist dermatological advice required

Dose source

International Hyperhidrosis Society Guidelines 2019

Why

Oral glycopyrronium is not registered in Egypt. Every glycopyrronium product in the register is an inhaled COPD device, so no brand and no price is shown - it is a real option a physician may import or compound, not one the pharmacy will hand over.

Cautions

CONTRAINDICATED in narrow-angle glaucoma, urinary retention, severe gastrointestinal obstruction, and severe ulcerative colitis.
Systemic anticholinergic effects include dry mouth, blurred vision, dizziness, constipation, and tachycardia.
Take on an empty stomach (1 hour before or 2 hours after meals).
No oral glycopyrronium tablet is on sale in Egypt - the register carries only inhaled COPD capsules. Do not substitute one; it is the wrong route and the wrong dose.

Egyptian brands

No Egyptian brand matched — prescribe by generic name.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.