Sofpironium bromide gel 5% (brand name: Ecracgel 5%) was launched in Korea in January as a treatment for primary axillary hyperhidrosis, drawing significant attention. This new drug addresses the long-standing clinical need for effective, safe, and non-invasive topical treatments that patients can self-apply, overcoming limitations of existing therapeutic options. Primary axillary hyperhidrosis (PAH) is defined as excessive localized sweating lasting more than six months without a clear cause, and according to recent epidemiological studies in Japan, the prevalence is approximately 5.75%, affecting about 5.3 million people, of which approximately 2.4 million have severe cases. Hyperhidrosis significantly impairs quality of life, causing distress and embarrassment in daily activities, with the degree of quality of life reduction being more severe than severe skin diseases such as psoriasis or atopic dermatitis. Despite this burden, only 4.4% of primary localized hyperhidrosis patients have experience receiving treatment at medical institutions, and only 0.7% maintain continuous treatment, leaving the majority of patients without adequate care. A symposium chaired by Professor Yi Won-joo from Kyungpook National University Hospital and Director Cho Hang-rae from OKims Dermatology shared clinical experiences from Japan and discussed the clinical significance and expected benefits of this new treatment option.