title: Treatment of Palmar Hyperhidrosis With Needle Injection Versus Low-Pressure Needle-Free Jet Injection of OnabotulinumtoxinA: An Open-Label Prospective Study.
abstract: BACKGROUND
  OnabotulinumtoxinA (OnabotA) injections are effective to treat palmar hyperhidrosis (HH) but are quite painful.
  
  
  OBJECTIVE
  To evaluate efficacy and pain of OnabotA injection using a needle-free jet apparatus compared with the traditional needle injection to treat palmar HH.
  
  
  METHODS
  Twenty patients were recruited for a prospective open-label study. Their right hand was injected with 1% lidocaine with a jet injector, after which OnabotA was injected with a needle. The left hand was injected with OnabotA directly using the jet injector. Pain scores were recorded for both techniques. At 0, 1, 3, and 6 months, severity of palmar HH was evaluated with the Hyperhidrosis Disease Severity Scale (HDSS).
  
  
  RESULTS
  One point reduction in the HDSS score at 1 month showed no statistical difference between both hands (p = .451). However, the HDSS score at 1 month from baseline dropped by 1.6 for the hand treated with traditional needle injection of OnabotA compared with 1.25 for the hand treated with jet injections (p = .031). There was no statistical difference in the pain on injection with both techniques (p = .1925).
  
  
  CONCLUSIONS
  This study demonstrates effective and relatively painless use of a low-pressure jet injector for OnabotA in palmar HH.
authors.affiliation: *All authors are affiliated with the Department of Medicine, Dermatology Division, Hôpital Saint-Luc du Centre Hospitalier de l'Université de Montréal, Montreal, Quebec.
authors.forename: Sophie
authors.initials: S
authors.lastname: Vadeboncoeur
authors.forename: Vincent
authors.initials: V
authors.lastname: Richer
authors.forename: Mélissa
authors.initials: M
authors.lastname: Nantel-Battista
authors.forename: Antranik
authors.initials: A
authors.lastname: Benohanian
mesh_terms: D065087:Acetylcholine Release Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D000328:Adult; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006229:Hand Dermatoses / Q000188:drug therapy*; D006801:Humans; D006945:Hyperhidrosis / Q000188:drug therapy*; D007277:Injections, Jet; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000517:prevention & control; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D065087:Acetylcholine Release Inhibitors; D019274:Botulinum Toxins, Type A