Botulinum toxin therapy for palmar hyperhidrosis

Shelley, Walter B.; Talanin, Nickolai Y.; Shelley, E. Dorinda

doi:10.1016/s0190-9622(98)70242-7

Cited by 139 publications

(109 citation statements)

References 10 publications

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“…Our results confirm the efficacy of treatment of palmar hyperhidrosis with injections of botulinum toxin [7, 8, 9, 10, 11, 12, 13, 14, 15]. However, a review of the literature indicates that there is so far no consensus on the way to use botulinum toxin for palmar hyperhidrosis.…”

Section: Discussionsupporting

confidence: 77%

“…This assumption may just be theoretical as the toxin may diffuse anyway. Because the ‘free nerve endings’ responsible for pain sensation are located superficially, it is also established that subepidermal injections are more painful than subcutaneous injections [7, 8, 14]. Earlier studies have reported pain during injections as one of the main disadvantages of treatment with botulinum toxin [7, 14].…”

Section: Discussionmentioning

confidence: 99%

“…Cryo treatment and application of EMLA cream have been used to reduce pain but they were considered as mildly effective or not effective [7, 12, 14]. Nerve block allowed less painful subepidermal injections [8]. Median and ulnar nerve blocks are a safe technique of anesthesia when taking care not to inject into the ulnar artery.…”

Section: Discussionmentioning

confidence: 99%

“…It helps in a variety of conditions including blepharospasm, strabismus, focal dystonias, spasmodic dysphonia, achalasia and has been recently used as a successful treatment of localized hyperhidrosis [3, 4, 5, 6]. Recent studies have reported that injections of botulinum toxin represent an effective therapeutic option for idiopathic palmar hyperhidrosis [7, 8, 9, 10, 11, 12, 13, 14, 15]. However, there is so far no consensus on the way to administer botulinum toxin for palmar hyperhidrosis.…”

Section: Introductionmentioning

confidence: 99%

“…Because the ‘free nerve endings’ responsible for pain sensation are located in the papillary dermis and epidermis, intracutaneous/subcutaneous injections are less painful than subepidermal ones [7, 8, 14]. However, they might be complicated by a higher incidence of muscle weakness [8, 10, 16]. Here, 23 adult patients with refractory palmar hyperhidrosis were treated with intracutaneous injections of botulinum toxin after median and ulnar nerve blocks at the wrists.…”

Section: Introductionmentioning

confidence: 99%

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Treatment of Idiopathic Palmar Hyperhidrosis with Botulinum Toxin

Vadoud-Seyedi

Heenen²,

Simonart³

2001

Dermatology

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Background: Botulinum toxin represents a novel therapeutic option for idiopathic palmar hyperhidrosis. However, so far there is no consensus on the way to administer botulinum toxin in this indication. Moreover, its use is limited by severe pain during the injections, especially with subepidermal injections close to ‘free nerve endings’. Objectives: To analyze the effectiveness and tolerability of intracutaneous injections of botulinum toxin after nerve blocks and to review the techniques of injections and the results reported by other groups. Methods: Twenty-three adult patients with refractory palmar hyperhidrosis were treated with intracutaneous injections of botulinum toxin after ulnar and median nerve blocks. Patients were followed up on a monthly basis. Results: In all patients botulinum toxin abolished sweating in the injected areas within 1 week. Anhidrosis lasted for 4–13 months. The intensity of pain was rated as absent (n = 13), mild (n = 8) or moderate (n = 2). Other side effects included hematoma (n = 2) and pain consecutive to nerve block (n = 1). Discussion: Intracutaneous injections of botulinum toxin after median and ulnar nerve block represent an effective and mildly painful technique to treat palmar hyperhidrosis and may be as safe as subepidermal injections.

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