Botulinum toxin: a new tool in the treatment of focal hyperhidrosis

Abstract 

Focal hyperhidrosis is a quantitative disturbance of sweat function which may involve multiple areas. It is a chronic condition and can cause the patient severe problems in social and professional relationships. Conventional treatments have proved to be marginally effective, impractical and/or with potentially significant side effects. Botulinum toxin type A is capable of blocking the cholinergic transmission to the eccrine glands, thus inhibiting sweat production. A series of 53 patients treated with Botulinum toxin for focal hyperhidrosis of multiple areas is reported. Intradermal injections of 2 mU were performed every 1.5 cm², with an average dose of 40 mU for each axilla, 50–60 mU for each palm and sole. The treatment has proved to be very effective in most cases, with the best results in the axilla. The mean duration of the effect was 6 months.