Botulinum toxin A injection therapy has been used successfully to reduce excessive sweating in all of the body areas affected in primary hyperhidrosis: axillary, palmoplantar, and facial/gustatory. Characterized as a “minimally invasive treatment option” compared to local surgery and endoscopic thoracic sympathectomy, the use of botulinum toxin A has become an important treatment option for patients not responding to more-conservative therapies.
OnabotulinumtoxinA (brand name Botox) has been approved for use in hyperhidrosis in Canada, the U.K. and other countries in Europe and South America (more than 25 countries total). In 2004, the US Food and Drug Administration (FDA) approved onabotulinumtoxinA for the treatment of severe primary axillary hyperhidrosis in patients unable to obtain relief using antiperspirants.
|Starch iodine test, with the darkened area showing location of excessive sweating before and after treatment with BTX-A. Photo courtesy of Markus Naumann, MD|