New NHS Cream for Excessive Sweating Could Reduce Sweat by 65%

A new prescription cream for excessive sweating has been recommended for use on the NHS, offering a potential new treatment option for thousands of adults living with a condition that can have a major impact on everyday life.

The treatment, glycopyrronium bromide (GPB) cream, is designed for adults with severe primary axillary hyperhidrosis, a condition that causes excessive sweating around the armpits without the level of heat or physical activity that would normally explain it.

According to NICE, around 75,000 people in England could potentially be eligible for the treatment.

The cream, marketed as AXHIDROX, is applied to the armpits at home, giving patients a topical option rather than requiring injections or tablets.

What is hyperhidrosis?

Sweating is a normal and important function that helps regulate body temperature. For people with hyperhidrosis, however, sweating can be excessive and may occur even when the weather is cool or there is little physical exertion.

Primary hyperhidrosis is associated with overactivity of the nerves that stimulate the sweat glands. It can affect areas including the underarms, hands, feet and face.

The condition can interfere with clothing choices, work, social activities and confidence. Some people may need to change clothes frequently or avoid situations where excessive sweating could become noticeable.

The NHS says treatment can include stronger antiperspirants, medicines, injections and other specialist approaches, depending on the individual and the area affected.

How does the new cream work?

GPB is an anticholinergic medicine. It works by blocking the action of acetylcholine, a chemical messenger involved in stimulating sweat glands.

Because the treatment is applied directly to the underarm area, it is intended to reduce sweating at the site where it is used.

Clinical trial results reported in the NICE evidence review found that sweating was reduced by around 65% after 12 weeks of treatment.

The results also suggested that some patients experienced substantially larger reductions.

Around half of patients achieved a reduction of more than 50% in sweat production, while approximately one third achieved a reduction of at least 75%.

About 22% experienced a reduction of more than 90%.

These figures suggest that the treatment may provide meaningful relief for some people, although individual responses can vary.

A different option from existing treatments

People with excessive sweating may already be offered prescription-strength antiperspirants containing aluminium chloride. While these can help, they may cause irritation, stinging or inflammation of the skin.

Other treatments include oral anticholinergic medicines. These can reduce sweating but may also affect other parts of the body because the medicine is not restricted to the underarms.

Botulinum toxin injections, commonly known as Botox, are another option. They can temporarily block the nerve signals responsible for sweating, although injections are not suitable or desirable for everyone.

The arrival of a licensed topical anticholinergic treatment therefore gives clinicians another option to consider for eligible patients.

What are the side effects?

As with any medicine, GPB cream can cause side effects.

The reported clinical trial data highlighted skin reactions as one of the more common problems, affecting around 15% of patients.

Other reported side effects included dry mouth, affecting approximately 12%, and dry eyes, affecting around 3%.

Constipation and blurred vision were also reported.

Because GPB is an anticholinergic medicine, patients need to take care when applying it. The product should not come into contact with the eyes, where it could cause significant dryness or other problems.

The treatment is designed to be applied using the pump rather than directly with the fingers, helping to reduce the chance of accidentally transferring the medicine to other parts of the body.

Patients should follow the instructions supplied with the medicine and any advice given by their doctor or pharmacist.

When will patients be able to get it?

The NICE recommendation is an important step towards wider NHS availability, but it does not necessarily mean that every eligible patient can receive the cream immediately.

It may take some time for NHS services to put the recommendation into practice and for local prescribing arrangements to be established.

Patients who believe they may have hyperhidrosis should speak to their GP or another healthcare professional. Excessive sweating can sometimes be caused by another medical condition or medication, so getting an appropriate assessment is important before starting treatment.

The new recommendation is specifically relevant to adults with severe primary axillary hyperhidrosis, meaning the treatment will not necessarily be appropriate for everyone who experiences excessive sweating.

Why the development matters

For people whose daily lives are dominated by excessive sweating, treatment is not simply about appearance.

Persistent sweating can affect professional interactions, socialising, clothing choices and confidence. Some people may avoid raising their arms, shaking hands or participating in activities because they are worried about visible sweat.

A treatment that can be applied at home could therefore be an attractive option for eligible patients, particularly those who have found other treatments ineffective, inconvenient or difficult to tolerate.

The reported 65% reduction after 12 weeks is encouraging, but it should not be interpreted as a guarantee that every patient will experience the same result.

The clinical evidence also shows that side effects are possible, meaning patients and clinicians will need to weigh the potential benefits against the risks.

For now, the NICE recommendation represents a significant development in the treatment of severe underarm hyperhidrosis. If NHS implementation proceeds as expected, thousands of eligible adults in England could eventually have access to another prescription option for managing excessive sweating.

Sources: NICE, Glycopyrronium bromide cream for treating severe primary axillary hyperhidrosis in adults; NHS, Excessive sweating (hyperhidrosis); clinical evidence reviewed by NICE.

Disclaimer: This article is for general information only and is not medical advice. Treatment decisions should be made with a qualified healthcare professional. NICE recommendations, NHS availability and prescribing arrangements may change, and patients should check the latest official guidance before seeking treatment.