title: Dilution of botulinum toxin A in lidocaine vs. in normal saline for the treatment of primary axillary hyperhidrosis: a double-blind, randomized, comparative preliminary study.
abstract: BACKGROUND
  Botulinum toxin A (BTX-A) is an effective and safe treatment modality for primary axillary hyperhidrosis. However, some patients experience considerable pain during injections.
  
  
  METHODS
  Dilution of botulinum toxin A in lidocaine vs. in normal saline for the treatment of primary axillary hyperhidrosis: a double-blind, randomized, comparative preliminary study.
  
  
  OBJECTIVE
  The aim of this study was to compare the efficacy, safety and pain tolerance of lidocaine-diluted BTX-A vs. saline-diluted BTX-A for the treatment of axillary hyperhidrosis.
  
  
  METHODS
  Eight patients were injected with 50 U of BTX-A diluted in 0.5 mL of saline and 1 mL of 2% lidocaine into one axilla and 50 U of BTX-A diluted in 1.5 mL of saline into the other axilla in a randomized fashion. The pain associated with the injections were self-assessed by the subjects using a 100-mm visual analogue scale (VAS).
  
  
  RESULTS
  Lidocaine-diluted BTX-A and saline-diluted BTX-A were similarly effective regarding the reduction in sweat production, the onset of sweat cessation and the duration of hypo/anhidrosis. Nevertheless, the pain VAS score during the injections was significantly lower in the axilla treated with lidocaine-diluted BTX-A than the one treated with saline-diluted toxin.
  
  
  CONCLUSIONS
  Preliminary study due to relatively small sample size.
  
  
  CONCLUSIONS
  Botulinum toxin A diluted in lidocaine causes significantly less pain than BTX-A diluted in saline, whereas it is is equally effective and safe as the latter one in treating axillary hyperhidrosis. Therefore, we suggest that lidocaine-diluted BTX-A may be a better treatment option for the patients with primary axillary hyperhidrosis.
authors.affiliation: Department of Dermatology, Baskent University Faculty of Medicine, Ankara, Turkey. tulinogulec@hotmail.com
authors.forename: A T
authors.initials: AT
authors.lastname: Güleç
mesh_terms: D000293:Adolescent; D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001365:Axilla; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D016022:Case-Control Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006945:Hyperhidrosis / Q000188:drug therapy*; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000008:administration & dosage*; D012965:Sodium Chloride / Q000008:administration & dosage; D018709:Statistics, Nonparametric
chemical_list: D000779:Anesthetics, Local; D009465:Neuromuscular Agents; D012965:Sodium Chloride; D008012:Lidocaine; D019274:Botulinum Toxins, Type A