title: Durability of botulinum toxin treatment for axillary hyperhidrosis.
abstract: OBJECTIVE
  Botulinum toxin injection effectively treats axillary hyperhidrosis. Durability estimates of 3-14 months, based on self re-referral may overestimate duration. Our objective was to determine treatment durability by active follow-up of patients.
  
  
  METHODS
  Audit of current practice.
  
  
  METHODS
  Patients presenting with severe primary axillary hyperhidrosis were actively followed up for 24 months after intradermal injections of Botulinum Toxin A (Dysport 120 units/axilla). A 10-point Likert Scale (1=worst imaginable symptoms, 10=absolute resolution) and the Hyperhidrosis Disease Severity Score (HDSS) were used at 1 day and 3, 6, 12 and 24 months. We offered re-treatment when symptoms returned to the pre-intervention state.
  
  
  RESULTS
  We treated 45 patients with a mean age of 29 (15-49) years of whom 36 (78%) were women. The median pre-treatment Likert score (i.q.r.) of 3 (2-3) improved to 10 (10-10) on day 1. Scores at 3 (n=44), 6 (n=43) and 12 (n=39) months were 10 (10-10), 8 (7.5-10), and 7 (5-8) respectively. The median 24-month score was 3 (3-6) for 35 patients, including 11 patients with scores >/=6 who have not required re-treatment. HDSS scores followed a similar pattern.
  
  
  CONCLUSIONS
  Axillary botulinum toxin treatment is durable. Patients experience gradual return of symptoms between 6 and 24 months. A minority do not require re-treatment at this time.
authors.affiliation: Department of Vascular Surgery, Worcestershire Royal Hospital, Charles Hastings Way, Worcester WR5 1DD, UK.
authors.forename: C E
authors.initials: CE
authors.lastname: Moffat
authors.forename: W G
authors.initials: WG
authors.lastname: Hayes
authors.forename: I K
authors.initials: IK
authors.lastname: Nyamekye
mesh_terms: D000293:Adolescent; D000328:Adult; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006945:Hyperhidrosis / Q000188:drug therapy*; D007271:Injections, Intradermal; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000008:administration & dosage*; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A