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Botulinum Toxin Injections (Botox®): Botulinum Toxin B and Treatment of Hyperhidrosis
Although approved for use only in cervical dystonia, BTX-B
(Myobloc, Elan Pharmaceticals) is reported to be used “off-label”
for hyperhidrosis and facial wrinkles.[11]
There are no published reports on BTX-B in hyperhidrosis,
but a case report of its use in a patient with palmar hyperhidrosis
who did not respond to BTX-A is of interest.[11]
After 2 treatments with 100 U of Botox to each palm 3 months
apart and little response, the patient was treated with
2500 U of BTX-B to each palm. He stopped having excessive
palmar sweating, but 2 days after injection complained of
blurred vision, indigestion, and dysphagia with a “dry
sore throat.” The indigestion and dysphagia cleared
within 10 days, but the blurred vision lasted for 3 weeks.
Since BTX-B has been reported to cause dysphagia and a dry
mouth when used at a dose of 5000 to 10000 U for cervical
dystonia, this patient’s symptoms were thought to be
due to the toxin. Further study of BTX-B with regard to
both safety and efficacy in the treatment of hyperhidrosis
is clearly needed.[11]
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