

In June 2018, the U.S. Food & Drug Administration (FDA) approved a new prescription topical treatment for axillary hyperhidrosis (underarm excessive sweating) called Qbrexza®. Qbrexza is owned by Journey Medical Corporation, headquartered in Scottsdale, Arizona.
International Hyperhidrosis Society founders and board of directors members Dr. Dee Anna Glaser (St. Louis University School of Medicine), Dr. Adelaide Hebert (University of Texas Medical School at Houston), and Dr. David Pariser (Eastern Virginia Medical School and Pariser Dermatology Associates) were involved in studying the safety and effectiveness of this new treatment and we congratulate them on its FDA-approval. It marks the first FDA sanctioning of a hyperhidrosis treatment since miraDry was FDA-cleared for use in the underarms in 2011, and since Botox® was FDA-approved in 2004.
Qbrexza (pronounced kew brex' zah) comes in individually packaged cloths (or wipes) that are to be used at home once per day to reduce underarm sweating. One wipe is intended for two underarms. The treatment works by blocking receptors responsible for sweat gland activation. In studies, Qbrexza was found to be effective and well-tolerated, even in children as young as 9 years old.
The active ingredient in Qbrexza is glycopyrronium tosylate, an anticholinergic formulation. As you may know, some hyperhidrosis sufferers take oral anticholinergics to help control their sweating but can experience side effects such as dry mouth, muscle cramps, and urinary retention. In theory, by applying the medication to the top of the skin instead of taking it by mouth, there may be a reduced incidence of such side effects. Also, there have been concerns over the years about older patients taking anticholinergics for long periods of time and increased risks of dementia – these concerns may, again, be reduced with Qbrexza because this is a medicine delivered through the skin to the affected area and not taken by mouth. One dermatologist agrees saying, “Yes, the topical agent lessens the risk of dementia in older adults.” Discuss it with your healthcare provider and find out what he or she thinks.
In research studies with Qbrexza, the most common side effects were:
Qbrexza was shown in clinical trials to improve sweating symptoms as soon as 1 week after starting the regimen. Studies also found that patients using Qbrexza wipes once daily for four weeks improved their “sweating severity” by nearly 25% to 30% (compared to 4% to 5% with placebo) and that measured sweat volume was reduced by 50% or more (in most patients.) The wipes were "well-tolerated" and any reported side effects were primarily mild to moderate (see above).
Of special note, Qbrexza is FDA-approved for patients who are 9 years old or older. We have long discussed on this website how there are few approved treatments for children and teens with hyperhidrosis. As Qbrexza is a non-invasive, at-home option that is actually approved for kids, it may lead to meaningful, practical relief in this under-served group.
Dr. Dee Anna Glaser, Dermatology Professor and Interim Chair at the St. Louis University School of Medicine and IHhS co-founder, says “This is a great addition to the treatments that we have for hyperhidrosis and based on my work in the clinical trials and feedback from study subjects, I am excited to offer this option to my patients. Moving forward, I hope there will be future investigation on the use of this therapy in nonaxillary hyperhidrosis, as well.”
Some questions, however, still remain:
Talk to your healthcare provider about whether Qbrexza might be a good choice for you, or not. Be sure to mention any other medications you are using including over-the-counter products.
To learn more, review all the Qbrexza studies just posted in our published literature website section (look for glycopyrronium tosylate in the title) and watch this website for updates as we try to get answers to the questions that remain.
Next Steps
Have you talked to your provider about excessive sweating? If not, now is the time! Learn more about how you and your healthcare team can work together to find the right treatment, or combination of treatments, to manage your hyperhidrosis.
Are you interested in trying Qbrexza for hyperhidrosis? As mentioned above, our Clinician Finder can help you locate practitioners who treat hyperhidrosis. Use it today!
Finally, you may want to consider participating in a clinical trial. Patients enrolled in clinical trials often receive treatments free of charge. Visit our Active Research page to find out more and whether you're eligible to participate in the latest studies.
And remember, because hyperhidrosis is a serious medical condition - you deserve insurance coverage and reimbursement for your medical visits and treatments, We've got tips to help you navigate the health insurance realm; visit Insurance Tools for more information.
Research and References
Ready to learn more about Qbrexza for the treatment of excessive sweating? Here are links to relevant scientific research: