Botulinum toxin type B: a new therapy for axillary hyperhidrosis.
Primary axillary hyperhidrosis is a disorder affecting mainly adolescents with significant adverse effects on quality of life. No ideal treatment exists, although recent data has demonstrated Botulinum toxin type A (Botox) as a treatment option. However, antibody formation may lead to loss of clinical benefit over time. Botulinum toxin type B (Neurobloc) has recently been introduced and may induce less immunogenic response.


OBJECTIVE
To investigate the efficacy of Neurobloc for axillary hyperhidrosis.


METHODS
Thirteen patients (22 axillae) were recruited to the study. The hyperhidrotic area was defined using the iodine-starch test then measured and photographed. 5000 MU of Neurobloc was administered subdermally. Patients were reviewed at 4, 8 and 12 weeks to assess outcome objectively (hyperhidrotic area measurements and photographs) and subjectively (sweat production and patient satisfaction).


RESULTS
There was a significant reduction in hyperhidrotic area at follow-up compared to baseline. Mean percentage reduction in hyperhidrotic area was 84, 87 and 81% at 4, 8 and 12 weeks (p=0.001, paired t test). Patient satisfaction was 100% throughout. Subjective mean percentage reduction in sweat production was 98, 96 and 90 at 4, 8 and 12 weeks. Side effects were minimal.


CONCLUSIONS
Neurobloc is an effective treatment for axillary hyperhidrosis.
Nelson
L
L
Vascular Unit, Aberdeen Royal Infirmary, Foresterhill, Aberdeen, UK. drlisanelson@hotmail.com
Bachoo
P
P
Holmes
J
J
D000328:Adult; D001365:Axilla; D001905:Botulinum Toxins / Q000627:therapeutic use*; D019274:Botulinum Toxins, Type A; D005260:Female; D006801:Humans; D006945:Hyperhidrosis / Q000188:drug therapy*; D008297:Male; D009466:Neuromuscular Blocking Agents / Q000627:therapeutic use*; D010865:Pilot Projects; D016896:Treatment Outcome
D009466:Neuromuscular Blocking Agents; C096323:rimabotulinumtoxinB; D001905:Botulinum Toxins; D019274:Botulinum Toxins, Type A