Effect Of Botulinum-A Toxin On Focal Hyperhidrosis

Abstract

Hyperhidrosis mean s abnonnall y excessive production of swea t. It does n ot present a threa t to life, but complaints usually ari se fi•om discomf011 and social embanassment. The pathogenesi s 1 s unkn own.

Localized idiopathic hyperhidrosis is a common disorder of sweating. The prefened sites of sweating are the axillae, palms, and soles. In excessive cases, sweat nms down the tnmk or dtips fi-om the hands and feet, a condition that is usually regarded as Lmacceptable in professi onal and p1ivate life. Profuse sweating leads to skin maceration, which may cause secondary infections.

Treatments include topical application of glutaraldehyde 10% in a buffered solution, acids, poldine methosulphate 1-4% in alcohol, fonnalin 1 % soaks, iontophoresis and metal salts, e.g., aluminium chlmide. UnfortLmately these methods are less valuable on the palms, soles, and axillae. They may cause allergic sensitization or stain the skin or clothes and are time consmning.

Systemic anticholinergic dmg therapy has been used to block th e effect of acetylcholine on the sweat glands. However, side effects are often more troublesome than the hyperhidrosis itself These include dryness of the mouth and blurring of vision due to paralysis of accommodation. More serious side effects as glaucoma, hype1thermia, and convulsions may occur.