Sofpironium bromide gel (brand name Ecracgel 5%) was launched in Korea in January as a treatment for primary axillary hyperhidrosis, marking a significant advancement in addressing long-standing clinical needs for effective, safe, and non-invasive topical treatment options. A recent symposium titled 'Changes and Expectations in Hyperhidrosis Patient Management' was held, with Professor Lee Won-joo from Kyungpook National University Hospital and Director Jo Hang-rae from Okims Dermatology serving as moderators, sharing clinical experiences from Japan. Hyperhidrosis is defined as excessive sweating triggered by heat, emotional stress, or excitement that significantly impacts daily life, with primary axillary hyperhidrosis (PAH) being the most common type. According to recent epidemiological surveys in Japan, the prevalence of PAH is approximately 5.75%, affecting about 5.3 million people, with approximately 2.4 million having severe cases classified as HDSS stages 3-4. The axilla has a lower sweating threshold than other body areas and limited evaporation capacity, making even small amounts of perspiration feel excessive. A critical concern is the low healthcare accessibility for patients. Only 4.4% of primary focal hyperhidrosis patients have visited medical institutions, and merely 0.7% continue treatment, leaving numerous patients suffering without proper care. Hyperhidrosis causes significant discomfort and embarrassment, severely impacting quality of life to a degree reportedly exceeding severe dermatological conditions like psoriasis and atopic dermatitis. The launch of Ecracgel 5% represents a paradigm shift in hyperhidrosis management, offering an effective, safe, and non-invasive treatment alternative that addresses previously unmet clinical needs.