title: Prospective open-label study of botulinum toxin type A in patients with axillary hyperhidrosis: effects on functional impairment and quality of life.
abstract: BACKGROUND
  Patients with primary axillary hyperhidrosis experience substantial functional impairment and reduced health-related quality of life (HRQOL). Few studies have comprehensively evaluated the effects of botulinum toxin type A (BoNT-A) on these symptoms.
  
  
  OBJECTIVE
  To prospectively assess the effects of BoNT-A on functional impairment associated with primary axillary hyperhidrosis.
  
  
  METHODS
  Patients treated with BoNT-A 50 U per axilla at baseline were assessed 4 and 12 weeks later. Outcome measures included functional impairment as assessed by the Hyperhidrosis Disease Severity Scale and the Hyperhidrosis Impact Questionnaire and dermatology-specific HRQOL as assessed by the Dermatology Life Quality Index.
  
  
  RESULTS
  At weeks 4 and 12 after BoNT-A treatment, 85% and 90% of patients achieved the a priori definition of treatment responder. Patients reported less occupational and emotional impairment, spent less time managing their hyperhidrosis, and had fewer difficulties in social situations. Adverse events were uncommon (5.5%), were mild, and did not require treatment. At study end, 53% of patients reported no dermatology-specific HRQOL impairment and 90% were satisfied with treatment.
  
  
  CONCLUSIONS
  Significant, meaningful, rapid, and durable reductions in disease severity and functional impairment, as well as improvements in HRQOL, were seen following BoNT-A treatment. BoNT-A was safe and well tolerated, producing high levels of patient satisfaction.
authors.affiliation: Sunnybrook and Women's Health Science Centre, Toronto, Ontario, Canada. n.solish@utoronto.ca
authors.forename: Nowell
authors.initials: N
authors.lastname: Solish
authors.forename: Antranik
authors.initials: A
authors.lastname: Benohanian
authors.forename: Jonathan W
authors.initials: JW
authors.lastname: Kowalski
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001365:Axilla; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D006801:Humans; D006945:Hyperhidrosis / Q000188:drug therapy*; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D011446:Prospective Studies; D011788:Quality of Life; D016896:Treatment Outcome
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A