Primary craniofacial hyperhidrosis

If initial treatment with topical antiperspirants is impractical to use on the face, systemic therapy as for generalised hyperhidrosis can be used first-line for primary craniofacial hyperhidrosis.

If there is no response to initial treatment, consider referring to a specialist (eg dermatologist or neurologist with expertise in sweating disorders) for botulinum toxin A injections. Botulinum toxin A injections should be administered by a specialist with expertise because administration in the craniofacial region may alter facial expressions or cause functional muscle weakness.

For refractory primary craniofacial hyperhidrosis, surgical sympathectomy may be considered as a last resort.