Botulinum toxin type A therapy for palmar and digital hyperhidrosis.
OBJECTIVE
We evaluated the efficacy of subepidermal injections of botulinum toxin type A on recalcitrant palmar and digital hyperhidrosis.


METHODS
Twenty patients with recalcitrant palmar and digital hyperhidrosis were treated with subepidermal injections of botulinum toxin. Nineteen patients completed the 12-month study. Injections were performed in 3 stages. The total dose of toxin for each hand, which included the palm, thenar eminence, and digits, was 165 units. Patients were followed up on a monthly basis.


RESULTS
Botulinum toxin significantly reduced sweat production in the treated areas. Anhidrosis lasted 9 months in 3 patients, 8 months in 3 patients, 7 months in 8 patients, 6 months in 3 patients, 5 months in 1 patient, and 4 months in 1 patient. Reduced sweating of the palm and digits continued in all patients for the 12-month evaluation period, with the greatest reduction of sweating in the nondominant hand. Mild weakness of the thumb occurred in 4 patients at a mean duration of 3 weeks, with the greatest duration being 6 weeks.


CONCLUSIONS
Botulinum toxin provides a safe and efficacious alternative in the treatment of recalcitrant palmar and digital hyperhidrosis.
Solomon
B A
BA
State University of New York, Health Science Center at Brooklyn, USA.
Hayman
R
R
D000293:Adolescent; D000328:Adult; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D005260:Female; D006225:Hand / Q000473:pathology; D006801:Humans; D006945:Hyperhidrosis / Q000473:pathology / Q000628:therapy*; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D016896:Treatment Outcome
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A