title: Focal hyperhidrosis: effective treatment with intracutaneous botulinum toxin.
abstract: OBJECTIVE
  To evaluate the effect of intracutaneous injections of botulinum toxin type A on excessive focal hyperhidrosis.
  
  
  METHODS
  Therapeutic before-and-after trial over 4 months.
  
  
  METHODS
  Neurological and dermatological university departments.
  
  
  METHODS
  Eleven patients with excessive axillary, palmar, or plantar hyperhidrosis fulfilling the following criteria: (1) local and systemic drug therapy had failed to improve their symptoms; (2) the patients were severely disabled with respect to their occupation and social activities; and (3) a successful treatment by botulinum toxin would obviate the need for destructive surgical procedures.
  
  
  METHODS
  Three mouse units of botulinum toxin (Botox) per 4-cm2 skin area was injected intracutaneously in 16 axillae, 8 palms, and 2 soles.
  
  
  METHODS
  Reduction of hyperhidrosis as documented by the Minor iodine-starch test and gravimetrical assessment of local spontaneous sweat production measured over 1 minute.
  
  
  RESULTS
  In all patients, botulinum toxin completely abolished sweating in the injected areas (P<.001) within 3 to 7 days. No relevant adverse effects occurred and no clinical recurrence of hyperhidrosis was observed within the follow-up period of up to 5 months. Occasionally, subclinical reactivation of sweat gland function was observed 4 months after treatment.
  
  
  CONCLUSIONS
  Intracutaneous botulinum toxin seems preferable to any hitherto used conservative or surgical procedures and may become the therapy of choice in pathological focal hyperhidrosis.
authors.affiliation: Department of Neurology, Bayerische Julius-Maximilians-Universität, Würzburg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Naumann
authors.forename: U
authors.initials: U
authors.lastname: Hofmann
authors.forename: I
authors.initials: I
authors.lastname: Bergmann
authors.forename: H
authors.initials: H
authors.lastname: Hamm
authors.forename: K V
authors.initials: KV
authors.lastname: Toyka
authors.forename: K
authors.initials: K
authors.lastname: Reiners
mesh_terms: D000328:Adult; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D006945:Hyperhidrosis / Q000628:therapy*; D007267:Injections / Q000379:methods; D008297:Male; D009465:Neuromuscular Agents / Q000008:administration & dosage*
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A