Treatment of Gustatory Sweating and Flushing

Abstract

The localized facial gustatory sweating and flushing (G.S.F) is discussed regarding occurrence and possible aetiology. Prophylactic resection of the auriculotemporal nerve in connexion with parotidectomy does not prevent the development of G.S.F. Resection of nerves carrying secretory fibres to the parotid gland (the auriculotemporal and glossopharyngeal nerves) may reduce the degree and extent of the syndrome but this result may not be permanent. These interventions are not recommended for G.S.F. following parotidectomy. Treatment with systemically administered anticholinergic agents in ordinary doses does not relieve the discomfort of a profuse syndrome. Topical treatment with an anticholinergic agent in a cream is considered to be a solution of the problem of how to treat distressing G.S.F. Trials on normal human subjects reveal that such creams elicit an inhibitory effect on sweating and flushing more marked on women than on men. Practical trials on patients with distressing G.S.F. reveal that a three per cent scopolamine hydrobromid cream is effective on the symptoms in all cases. Women are more sensitive to the cream than men. Topical treatment with a cream containing an anticholinergic agent in an individually appropriate concentration is recommended for the treatment of G.S.F.