Treatment of Primary Axillary Hyperhidrosis with Botulinum Toxin Type A: Our Experience in 50 Patients from 2007 to 2010

Abstract

Background. Local injections of Botulinum toxin type A (BTX-A) are an effective and safe solution for primary bilateral axillary hyperhidrosis. Traditional treatments are often ineffective and difficult to tolerate. This study was performed to assess the efficacy and safety of Botulinum toxin type A in the treatment of these diseases and to evaluate the reliability of patient's subjective rating in the timing of repeat injections. Methods. From 2007 to 2008, we included in the study and treated a total of 50 patients, and we used the Minor's iodine test and the hyperhidrosis diseases severity scale as initial inclusion criteria and also for evaluating the followup, comparing to patient's subjective rating. We used also a specific questionnaire to evaluate the level of pain, the onset of the effect, any eventual adverse effect of the treatment, the onset of compensatory hyperhidrosis, and the global grade of satisfaction. The data were analyzed using standard statistical methods. Results. 88% of patients were totally satisfied and all patients repeated the treatment during all the study. The symptom-free interval was in median 6 months with an average improving of HDSS of 1.5 points. In 86%, there was a complete accordance between the subjective patient's demand of the repetition of the treatment and the positivity to Minor test and HDSS. No major side effects happened. Conclusion. Local injections of Botulinum toxin type A (BTX-A) result in an effective and safe solution for bilateral axillary primary hyperhidrosis for the absence of significant morbidity, side effects, and lack of efficacy or duration. The only defects are the need of repetition of the treatment and relative costs.

Results of a 10‐year follow‐up study of botulinum toxin A therapy for primary axillary hyperhidrosis in Australia

“…A low rate of compensatory sweating in our cohort was consistent with findings in larger international studies …”

Evaluation of Botox Treatment for Patients With Primary Axillary Hyperhidrosis in Basrah

“…Several studies have mentioned the dose of botulinum toxin that is required for patients with axillary hyperhidrosis. A minimum botulinum toxin dose of 50 units per axilla is necessary to cause anhidrosis in healthy volunteers 7,8 . In our study , the dose of 50 U per axilla was enough in 16 cases.…”

“…It is an easy treatment and can be administered under topical anesthesia, local anesthesia, or even sedation. It has the disadvantages of being costy in addition to the discomfort associated with multiple injections and a temporary therapeutic effect (with an average duration of 7 months) [5][6][7][8] . Surgical treatment: This include endoscopic thoracic sympathectomy, which is the only definitive surgical treatment for hyperhidrosis, of both palmar and axillary forms.…”

Management of Hyperhidrosis: A Proposal Protocol for Trainees

“…There are two options; the first being the use of botulinum toxin injections as first line treatment [14]. These injections have good clinical outcomes but require repeated administration and can be painful for patients [15].…”