ROLE OF BOTULINUM TOXIN IN THE MANAGEMENT OF PALMAR AND AXILLARY HYPERHIDROSIS

Abstract

The studies have shown Botulinum toxin A to be a highly effective treatment for hyperhidrosis. It has the potential to change current treatment strategies for this distressing disorder . The reason for this is as follows: The adverse events with botulinum toxin treatment are mild or moderate and occur with a similar incidence to placebo. With the present regimen, treatment lasts for a median 10 months. This means that treatment may have to be repeated once a year. Some patients need treatment more often but seldom more than twice a year. More frequent therapies should be avoided. High doses and frequent injections have been associated in dystonias and the occurrence of resistance to botulinum toxin. If frequent therapies are necessary, surgical therapy may be considered. It results in highly significant reduction in sweating for the majority of patients: 95% of patients respond to treatment in just one week. 82% of patients are still responders after 16 weeks. Resistance may occur in 5% of cases. Antibodies against the toxins are presumed to be responsible for most cases of resistance. Treatment response has been reported to persist for up to 7 months. Productivity and performance at work is significantly improved. Administrated as Intradermal injections which is a minimally invasive procedure. More than 9 out of 10 patients express improvement over preVIous treatments. 83% reduction in sweat production after one week. Treatment of hyperhidrosis with botulinum toxin avoids the many complications of the surgical therapy.