Aesthet Surg J 2012 Feb;32(2):238-44.
Treatment of hyperhidrosis with botulinum toxin
Melissa A Doft 1, Krista L Hardy, Jeffrey A Ascherman
Affiliations expand PMID: 22328694 DOI: 10.1177/1090820X11434506
Botulinum toxin type A is a safe and effective method of treating local hyperhidrosis, providing more lasting results than topical treatments without the need for invasive surgical procedures. Although most useful for axillary hyperhidrosis, botulinum toxin injections can also be effective in treating palmar and plantar hyperhidrosis. The effects of botulinum toxin last an average of six to nine months, and the treatment is associated with a high degree of patient satisfaction. This material serves as a guide to pretreatment assessment, injection techniques, and posttreatment care. Hyperhidrosis is defined as sweating in excess of what is needed to regulate body temperature. About 1.3 million Americans have been diagnosed with severe hyperhidrosis. Affected patients are hindered in professional and social situations, leading to reduced physical and emotional well-being, difficulties in personal relationships and social stigmatization. Primary hyperhidrosis can be treated surgically or non-surgically. First-line nonsurgical therapies that include topical antiperspirants such as aluminum chloride are often short-acting and require frequent reapplication, are ineffective in reducing sweat production, and in sensitive individuals may cause irritant dermatitis. Surgical procedures include endoscopic transthoracic sympathectomy (ETS), arthroscopic removal of sweat glands. These treatments are invasive, can be associated with serious complications and high recurrence rates, and require operative fees, recovery time, and anesthesia. Therefore, the ideal treatment is the one that offers safety and is less invasive than surgery, has longevity and is more tolerable than current agents. With these criteria in mind, botulinum toxin type A has emerged as an important treatment option for patients affected with localized hyperhidrosis.