Botulinum toxin for hyperhidrosis: A review

American Journal of Clinical Dermatology

Volumn 10, Issue 2, 2009, Pages 87-102

  Grunfeld, Alexander ^a   Murray, Christian A ^a   Solish, Nowell ^a  

^a WOMEN S COLLEGE HOSPITAL   (Canada)

Author keywords

[No Author keywords available]

Indexed keywords

ALUMINUM CHLORIDE; ANESTHETIC AGENT; ANTIDEPRESSANT AGENT; ANTIEMETIC AGENT; ASTRINGENT AGENT; BOTULINUM TOXIN A; BOTULINUM TOXIN B; CHOLINERGIC RECEPTOR BLOCKING AGENT; GLYCOPYRRONIUM BROMIDE; IODINE; STARCH;

ALGORITHM; ANESTHESIA; BLURRED VISION; CLINICAL TRIAL; COLORIMETRY; CONSERVATIVE TREATMENT; CONSTIPATION; DISEASE SEVERITY; EXCISION; HEMATOMA; HUMAN; HYPERHIDROSIS; INJECTION PAIN; IONTOPHORESIS; MINIMALLY INVASIVE SURGERY; MUSCLE WEAKNESS; PARESTHESIA; PRIORITY JOURNAL; QUALITY OF LIFE; RATING SCALE; REVIEW; SYMPATHECTOMY; TACHYCARDIA; URINE RETENTION; XEROSTOMIA;

EID: 61949337001     PISSN: 11750561     EISSN: None     Source Type: Journal    
DOI: 10.2165/00128071-200910020-00002     Document Type: Review

References (192)

1. Iwase S, Ikeda T, Kitazawa H, et al. Altered response in cutaneous sympathetic outflow to mental and thermal stimuli in primary palmoplantar hyperhidrosis. J Auton Nerv Syst 1997; 64: 65-73
2. Adar R, Kurchin A, Zweig A, et al. Palmar hyperhidrosis and its surgical treatment. Ann Surg 1977; 186 (1): 34-41
3. Kreyden OP, Schmid-Grendelmeier P, Burg G. Idiopathic localized unilateral hyperhidrosis. Arch Dermatol 2001; 137: 1622-5
4. Hamm H, Naumann M, Kowalski JW, et al. Primary focal hyperhidrosis: disease characteristics and functional impairment. Dermatology 2006; 212: 343-53
5. Lear W, Kessler E, Solish N, et al. An epidemiological study of hyperhidrosis. Dermatol Surg 2007; 33: S69-75
6. Strutton DR, Kowalski JW, Glaser DA, et al. US prevalence of hyperhidrosis and impact on individuals with axillary hyperhidrosis: results from a national survey. J Am Acad Dermatol 2004; 51: 241-8
7. Atkins JL, Butler PEM. Hyperhidrosis: a review of current management. Plast Reconstr Surg 2001; 110 (1): 222-8
8. Haider A, Solish N. Hyperhidrosis: an approach to diagnosis and management. Dermatol Nurs 2004; 16 (6): 515-23
9. Leung AKC, Chan PYH, Choi MCK. Hyperhidrosis. Int J Dermatol 1999; 38: 561-7
10. Stolman LP. Treatment of hyperhidrosis. Curr Ther 1998; 16: 853-67
11. Haider A, Solish N, Lowe NJ. Management of hyperhidrosis. In: Carruthers A, Carruthers J, editors. Procedures in cosmetic dermatology series: Botulinum toxin. Philadelphia (PA): Saunders, 2004: 83-92
12. Christophers E, Kruger G. Psoriasis. In: Fitzpatrick TB, Eisen AZ, Wolff K, editors. Dermatology in general medicine. 3rd ed. New York: McGraw-Hill, 1987: 461-91
13. Glaser DA, Kessler E. A demographical analysis of hyperhidrosis [abstract]. J Am Acad Dermatol 2007; 56 (2): AB46
14. Mosek A, Korczyn A. Hyperhidrosis in palms and soles. In: Korczyn A, editor. Handbook of autonomic nervous system dysfunction. New York: Marcel Dekker, 1995: 167-77
15. Hamm H, Naumann M, Kozma C, et al. Primary focal hyperhidrosis: comparison of functional impairment, health-related quality of life, and medical history across a large cohort of patients by focal location and nonhyperhidrotic controls [abstract]. J Am Acad Dermatol 2005; 52 (3): 57
16. Kaufmann H, Saadia D, Polin C, et al. Primary hyperhidrosis: evidence for autosomal dominant inheritance. Clin Auton Res 2003; 13: 96-8
17. Draelos ZD. Antiperspirants and the hyperhidrosis patient. Dermatol Ther 2001; 14: 220-4
18. Hölzle E. Topical pharmacological treatment. Curr Probl Dermatol 2002; 30: 30-43
19. Filosto M, Bertolasi L, Fincati E, et al. Axillary injection of botulinum A toxin in a patient with muscle cramps associated with severe axillary hyperhidrosis. Acta Neurol Belg 2001; 101: 121-3
20. Duller P, Gentry WD. Use of biofeedback in treating chronic hyperhidrosis: a preliminary report. Br J Dermatol 1980; 103: 143-7
21. Elgart ML, Fuchs G. Tapwater iontophoresis in the treatment of hyperhidrosis: use of the Drionic device. Int J Dermatol 1987; 26 (3): 194-7
22. Odia S, Vocks E, Rakoski J, et al. Successful treatment of dyshidrotic hand eczema using tap water iontophoresis with pulsed direct current. Acta Derm Venereol 1996; 76: 472-4
23. Wollina U, Uhlemann C, Elstermann D, et al. Therapy of hyperhidrosis with tap water iontophoresis: positive effect on healing time and lack of recurrence in hand-foot eczema. Hautarzt 1998; 49 (2): 109-13
24. Benohanian A. Antiperspirants and deodorants. Clin Dermatol 2001; 19: 398-405
25. Glogau RG. Botulinum A neurotoxin for axillary hyperhidrosis: no sweat Botox. Dermatol Surg 1998; 24: 817-9
26. Glogau RG. Treatment of palmar hyperhidrosis with botulinum toxin. Semin Cutan Med Surg 2001; 20 (2): 101-8
27. Weber A, Heger S, Sinkgraven R, et al. Psychosocial aspects of patients with focal hyperhidrosis: marked reduction of social phobia, anxiety and depression and increased quality of life after treatment with botulinum toxin A. Br J Dermatol 2005; 114: 342-5
28. Cina CS, Clase CM. The Illness Intrusiveness Rating Scale: a measure of severity in individuals with hyperhidrosis. Qual Life Res 1999; 8: 693-8
29. Spalding JR, Kowalski JW, Lee J, et al. Effect of pharmacologic treatment on dermatologic-specific quality of life (QOL): a comparison of botulinum toxin type-A (BT-A) for primary focal hyperhidrosis (HH) to medical treatments for other dermatological diseases [abstract]. J Am Acad Dermatol 2004; 50 (3): 51
30. Swartling C, Naver H, Lindberg M. Botulinum A toxin improves life quality in severe primary focal hyperhidrosis. Eur J Neurol 2001; 8: 247-52
31. Naumann M, Lowe NJ, Kumar CR, et al. Botulinum toxin type A is a safe and effective treatment for axillary hyperhidrosis over 16 months. Arch Dermatol 2003; 139: 731-6
32. Naumann M, Hamm H, Lowe NJ. Effect of botulinum toxin type A on quality of life measures in patients with excessive axillary sweating: a randomized controlled trial. Br J Dermatol 2002; 147: 1218-26
33. Campanati A, Penna L, Guzzo T, et al. Quality-of-life assessment in patients with hyperhidrosis before and after treatment with botulinum toxin: results of an open-label study. Clin Ther 2003; 25: 298-308
34. Solish N, Benohanian A, Kowalski JW. Prospective open-label study of botulinum toxin type Ain patients with axillary hyperhidrosis: effects on functional impairment and quality of life. Dermatol Surg 2005; 31 (4): 405-13
35. Sato K, Kang WH, Saga K, et al. Biology of sweat glands and their disorders: I. Normal sweat gland function. J Am Acad Dermatol 1989; 20: 537-63
36. Wilke K, Martin A, Terstegen L, et al. A short history of sweat gland biology. Int J Cosmet Sci 2007; 29: 169-79
37. Kreyden OP, Scheidegger EP. Anatomy of the sweat glands, pharmacology of botulinum toxin, and distinctive syndromes associated with hyperhidrosis. Clin Dermatol 2004; 22: 40-4
38. Sato K, Kang WH, Saga K, et al. Biology of sweat glands and their disorders: II. Disorders of sweat gland function. J Am Acad Dermatol 1989; 20: 713-26
39. Bovell DL, Clunes MT, Elder HY, et al. Ultrastructure of the hyperhidrotic eccrine sweat gland. Br J Dermatol 2001; 145: 298-301
40. Manca D, Valls-Sole J, Callejas MA. Excitability recovery curve of the sympathetic skin response in healthy volunteers and patients with palmar hyperhidrosis. Clin Neurophysiol 2000; 111: 1767-70
41. Murray CA, Cohen JL, Solish N. Treatment of focal hyperhidrosis. J Cutan Med Surg 2007; 11 (2): 67-77
42. Shih C-J, Lin MT. Thermoregulatory sweating in palmar hyperhidrosis before and after upper thoracic sympathectomy. J Neurosurg 1979; 50: 88-94
43. Shih C-J, Wu J-J, Lin M-T. Autonomic dysfunction in palmar hyperhidrosis. J Auton Nerv Syst 1983; 8: 33-43
44. Lin TK, Chee ECY, Chen HJ, et al. Abnormal sympathetic skin response in patients with palmar hyperhidrosis. Muscle Nerve 1995; 18 (8): 917-9
45. Birner P, Heinzel H, Schindl M, et al. Cardiac autonomic function in patients suffering from primary focal hyperhidrosis. Eur Neurol 2000; 44 (2): 112-6
46. Hornberger J, Grimes K, Naumann M, et al. Recognition, diagnosis, and treatment of primary focal hyperhidrosis. J Am Acad Dermatol 2004; 51 (2): 274-86
47. Solish N, Bertucci V, Dansereau A, et al. A comprehensive approach to the recognition, diagnosis, and severity-based treatment of focal hyperhidrosis: recommendations of the Canadian Hyperhidrosis Advisory Committee. Dermatol Surg 2007; 33: 908-23
48. Krogstad A-L, Piechnik K. Are patients better than the laboratory in assessing sweating? Validation study. Dermatol Surg 2005; 31 (11): 1434-9
49. Vadoud-Seyedi J, Simonart T. Treatment of axillary hyperhidrosis with botulinum toxin type A reconstituted in lidocaine or in normal saline: a randomized, side-by-side, double-blind study. Br J Dermatol 2007; 156: 986-9
50. Solish N, Benohanian A, Kowalski JW. Prospective open-label study of botulinum toxin type A in patients with axillary hyperhidrosis: effects on functional impairment and quality of life. Dermatol Surg 2005; 31 (4): 405-13
51. Kowalski JW, Eadie N, Daggett S, et al. Validity and reliability of the Hyperhidrosis Disease Severity Scale (HDSS). Poster presented at the 62nd Annual Meeting of the American Academy of Dermatology; 2004 Feb 6-10; Washington, DC
52. Krogstad A-L, Skymne A, Pegenius G, et al. Evaluation of objective methods to diagnose palmar hyperhidrosis and monitor effects of botulinum toxin treatment. Clin Neurophysiol 2004; 115: 1909-16
53. Stefaniak T, Vingerhoets A, Proczko-Markuszewska M. The importance of quantitative evaluation in the follow-up after sympathectomy for primary hyperhidrosis. Clin Auton Res 2007; 17: 122-3
54. Rompel R, Scholz S. Subcutaneous curettage vs. injection of botulinum toxin A for treatment of axillary hyperhidrosis. J Eur Acad Dermatol Venereol 2001; 15: 207-11
55. Swinehart JM. Treatment of axillary hyperhidrosis: combination of the starch-iodine test with the tumescent liposuction technique. Dermatol Surg 2000; 26: 392-6
56. Naumann M, Lowe NJ. Botulinum toxin type A in treatment of bilateral primary axillary hyperhidrosis: randomised, parallel group, double blind, placebo controlled trial. BMJ 2001; 323: 596-9
57. Haider A, Solish N. Focal hyperhidrosis: diagnosis and management. CanMed Assoc J 2005; 172 (1): 69-75
58. Cheung JS, Solomon BA. Disorders of sweat glands: hyperhidrosis. Unapproved treatments. Clin Dermatol 2002; 20: 638-42
59. Lowe NJ, Campanati A, Bodokh I, et al. The place of botulinum toxin type A in the treatment of focal hyperhidrosis. Br J Dermatol 2004; 151: 1115-22
60. Benohanian A, Boudjikanian A, Paylan Y. Palmar and plantar hyperhidrosis: a practical management algorithm. Therapy 2007; 4 (3): 279-83
61. Scholes KT, Crow KD, Ellis JP, et al. Axillary hyperhidrosis treated with alcoholic solution of aluminum chloride hexahydrate. BMJ 1978; 2: 84-5
62. Reifenrath WG, Prystowsky SD, Nonomura JH, et al. Topical glutaraldehyde: percutaneous penetration and skin irritation. Arch Dermatol Res 1985; 277 (3): 242-4
63. Juhlin L, Hansson H. Topical glutaraldehyde for plantar hyperhidrosis. Br J Dermatol 1968; 97: 327-30
64. Grice K. Treatment of hyperhidrosis. Clin Exp Dermatol 1982; 7: 183-8
65. Juhlin L, Hansson H. Topical glutaraldehyde for plantar hyperhidrosis. Arch Dermatol 1968; 97: 327-30
66. Grimalt R, Tordera PD, Callejas MA. Topical atropine sulfate for the treatment of axillary hyperhidrosis. J Cosmet Dermatol 2006; 5: 294-6
67. Madan V, Beck MH. Urinary retention caused by topical glycopyrrolate for hyperhidrosis. Br J Dermatol 2006; 155: 634-5
68. Macmillan FS, Reller HH, Synder FH. The antiperspirant action of topically applied anticholinergics. J Invest Derm 1964; 43: 363-77
69. Agren-Jonsson S, Magnusson B. Sensitization to propantheline bromide, trichlorocarbanilide and propylene glycol in an antiperspirant. Contact Dermat 1976; 2 (2): 79-80
70. Luh JY, Blackwell TA. Craniofacial hyperhidrosis successfully treated with topical glycopyrrolate. South Med J 2002; 95 (7): 756-8
71. Seukeran DC, Highet AS. The use of topical glycopyrrolate in the treatment of hyperhidrosis. Clin Exp Dermatol 1998; 23: 204-5
72. Hays LL. The Frey syndrome: a review and double blind evaluation of the topical use of a new anticholinergic agent. Laryngoscope 1978; 88: 1796-824
73. Atkin SL, Brown PM. Treatment of diabetic gustatory sweating with topical glycopyrrolate cream. Diabet Med 1996; 13 (5): 493-4
74. Shaw JE, Abbott CA, Tindle K, et al. A randomised controlled trial of topical glycopyrrolate, the first specific treatment for diabetic gustatory sweating. Diabetologia 1997; 40 (3): 299-301
75. Kim WO, Kil HK, Yoon DM, et al. Treatment of compensatory gustatory hyperhidrosis with topical glycopyrrolate. Yonsei Med J 2003; 44 (4): 579-82
76. Juhlin L, Evers H, Broberg F. Inhibition of hyperhidrosis by topical application of a local anesthetic composition. Acta Derm Venereol 1979; 59 (6): 556-9
77. Abell E, Morgan K. The treatment of idiopathic hyperhidrosis by glycopyrronium bromide and tap water iontophoresis. Br J Dermatol 1974; 91: 87-91
78. Dolianitis C, Scarff CE, Kelly J, et al. Iontophoresis with glycopyrrolate for the treatment of palmoplantar hyperhidrosis. Australas J Dermatol 2004; 45: 208-12
79. Sloan JB, Soltani K. Iontophoresis in dermatology: a review. J Am Acad Dermatol 1986; 15 (4): 671-84
80. Hölzle E, Alberti N. Long term efficacy and side effects of tap water iontophoresis for palmoplantar hyperhidrosis: the usefulness of home therapy. Dermatologica 1987; 175: 126-35
81. Shrivastava SN, Singh G. Tap water iontophoresis in palmo-plantar hyperhidrosis. Br J Dermatol 1977; 96: 189-95
82. Mirakhur RK, Dundee JW, Jones CJ. Evaluation of the anticholinergic actions of glycopyrronium bromide. Br J Clin Pharmacol 1978; 5: 77-84
83. Bajaj V, Langtry JAA. Use of oral glycopyrronium bromide in hyperhidrosis. Br J Dermatol 2007; 157: 118-21
84. Bushara KO, Park DM, Jones JC, et al. Botulinum toxin: a possible new treatment for axillary hyperhidrosis. Clin Exp Dermatol 1996; 21: 276-8
85. Heckmann M, Ceballos-Baumann AO, Plewig G. Botulinum toxin A for axillary hyperhidrosis (excessive sweating). N Engl J Med 2001; 344 (7): 488-93
86. Naumann M, Bergmann I, Hamm H, et al. Focal hyperhidrosis: effective treatment with intracutaneous botulinum toxin. Arch Dermatol 1998; 134: 301-4
87. Naver H, Swartling C, Aquilonius SM. Palmar and axillary hyperhidrosis treated with botulinum toxin: one-year clinical follow-up. Eur J Neurol 2000; 7: 55-62
88. Tan SR, Solish N. Long-term efficacy and quality of life in the treatment of focal hyperhidrosis with botulinum toxin A. Dermatol Surg 2002; 28 (6): 495-9
89. Shelley WB, Talanin NY, Shelley ED. Botulinum toxin therapy for palmar hyperhidrosis. J Am Acad Dermatol 1998; 38: 227-9
90. Solomon BA, Hayman R. Botulinum toxin type A therapy for palmar and digital hyperhidrosis. J Am Acad Dermatol 2000; 42 (6): 1026-9
91. Schnider P, Binder M, Berger T, et al. Botulinum A toxin injection in focal hyperhidrosis. Br J Dermatol 1996; 134 (6): 1160-1
92. Naumann M, Flachenecker P, Brocker EB, et al. Botulinum toxin for palmar hyperhidrosis. Lancet 1997; 349: 252
93. Holmes S, Mann C. Botulinum toxin in the treatment of palmar hyperhidrosis. J Am Acad Dermatol 1998; 39: 1040-1
94. Saadia D, Voustianiouk A, Wang AK, et al. Botulinum toxin type A in primary palmar hyperhidrosis. Neurology 2001; 57: 2095-9
95. Schnider P, Binder M, Auff E, et al. Double-blind trial of botulinum A toxin for the treatment of focal hyperhidrosis of the palms. Br J Dermatol 1997; 136: 548-52
96. Boger A, Herath H, Rompel R, et al. Botulinum toxin for treatment of craniofacial hyperhidrosis. J Neurol 2000; 415: 857-61
97. Trindade de Almeida AR, Marques E, de Almeida J, et al. Pilot study comparing the diffusion of two formulations of botulinum toxin type A in patients with forehead hyperhidrosis. Dermatol Surg 2007; 33: S37-43
98. Lowe NJ, Yamauchi PS, Lask GP, et al. Efficacy and safety of botulinum toxin type A in the treatment of palmar hyperhidrosis: a double-blind, randomized, placebo-controlled study. Dermatol Surg 2002; 28 (9): 822-7
99. Wu WH, Ma S, Lin JT, et al. Surgical treatment of axillary osmidrosis: an analysis of 343 cases. Plast Reconstr Surg 1994; 94 (2): 288-94
100. Endo T, Nakayama Y. Surgical treatment of axillary osmidrosis. Ann Plast Surg 1993; 30: 136-9
101. Yoshikata R, Yanai A, Takei T, et al. Surgical treatment of axillary osmidrosis. Br J Plast Surg 1990; 43: 483-5
102. Ou LF, Yan RS, Chen IC, et al. Treatment of axillary bromhidrosis with superficial liposuction. Plast Reconstr Surg 1998; 102: 1479-85
103. Park S. Very superficial ultrasound-assisted lipoplasty for the treatment of axillary osmidrosis. Aesth Plast Surg 2004; 24 (4): 275-9
104. Tsai RY, Lin JY. Experience of tumescent liposuction in the treatment of osmidrosis. Dermatol Surg 2001; 27: 446-8
105. Chung S, Yoo WM, Park YG, et al. Ultrasonic surgical aspiration with endoscopic confirmation for osmidrosis. Br J Plast Surg 2000; 53 (3): 212-4
106. Tung TC. Endoscopic shaver with liposuction for treatment of axillary osmidrosis. Ann Plast Surg 2001; 46 (4): 400-4
107. Bechara FG, Sand M, Tomi NS, et al. Repeat liposuction-curettage treatment of axillary hyperhidrosis is safe and effective. Br J Dermatol 2007; 157: 739-43
108. Tsai RY. Treatment of excessive axillary sweat syndromes (hyperhidrosis, osmidrosis, bromhidrosis) with liposuction. In: Shiffman MA, Di Giuseppe A, editors. Liposuction: principles and practice. Berlin: Springer; 2006: 496-501
109. Boni R. Tumescent suction curettage in the treatment of axillary hyperhidrosis: experience in 63 patients. Dermatology 2006; 213 (3): 215-7
110. Lee D, Cho SH, Kim YC, et al. Tumescent liposuction with dermal curettage for treatment of axillary osmidrosis and hyperhidrosis. Dermatol Surg 2006; 32: 505-11
111. Perng CK, Yeh FL, Ma H, et al. Is the treatment of axillary osmidrosis with liposuction better than open surgery? Plast Reconstr Surg 2003; 114: 93-7
112. Reisfeld R, Nguyen R, Pnini A. Endoscopic thoracic sympathectomy for hyperhidrosis: experience with both cauterization and clamping methods. Surg Laparosc Endosc Percutan Techn 2002; 12: 255-67
113. Wilkinson H. Radiofrequency percutaneous upper-thoracic sympathectomy. N Engl J Med 1984; 311: 43-6
114. Chou SH, Kao EL, Lin CC, et al. The outcome of ganglion clipping in hyperhidrosis and blushing. Clin Auton Res 2006; 16: 240-2
115. Dumont P, Denoyer A, Robin P. Long-term results for thoracoscopic sympathectomy for hyperhidrosis. Ann Thorac Surg 2004; 78: 1801-7
116. Neumayer C, Panhofer P, Jakesz R, et al. Surgical treatment of facial hyperhidrosis and blushing: mid-term results after endoscopic sympathetic block and review of the literature. Eur Surg 2005; 37 (3): 127-36
117. Moya J, Ramos R, Morera R, et al. Thoracic sympathicolysis for primary hyperhidrosis: a review of 918 procedures. Surg Endosc 2006; 20: 598-602
118. Furlan AD, Mailis A, Papagapiou M. Are we paying a high price for surgical sympathectomy? A systematic literature review of late complications. J Pain 2000; 1 (4): 245-57
119. Gossot D, Galetta D, Pascal A, et al. Long-term results of endoscopic thoracic sympathectomy for upper limb hyperhidrosis. Ann Thorac Surg 2003; 75: 1075-9
120. Zacherl J, Huber ER, Imhof M, et al. Long-term results of 630 thoracoscopic sympathicotomies for primary hyperhidrosis: the Vienna experience. Eur J Surg 1998; 164 Suppl. 580: 43-6
121. Leseche G, Castier Y, Thabut G, et al. Endoscopic transthoracic sympathectomy for upper limb hyperhidrosis: limited sympathectomy does not reduce postoperative compensatory sweating. J Vasc Surg 2003; 37 (1): 124-8
122. Simpson LL. The origin, structure, and pharmacological activity of botulinum toxin. Pharmacol Rev 1981 Sep; 33 (3): 155-88
123. Simonetta Moreau M, Cauhepe C, Magues JP, et al. A double-blind, randomized, comparative study of Dysport vs. Botox in primary palmar hyperhidrosis. Br J Dermatol 2003; 149: 1041-5
124. Krack P, Deuschl G, Benecke R, et al. Dose standardization of botulinum toxin. Mov Disord 1998; 13 (4): 749-51
125. Talarico-Filho S, do Nascimento MM, de Macedo FS, et al. A double-blind, randomized, comparative study of two type A botulinum toxins in the treatment of primary axillary hyperhidrosis. Dermatol Surg 2007; 33: S44-50
126. Klein AW. Contraindications and complications with the use of botulinum toxin. Clin Dermatol 2004; 22: 66-75
127. Swartling C, Naver H, Pihl-Lundin I, et al. Sweat gland morphology and periglandular innervation in essential palmar hyperhidrosis before and after treatment with intradermal botulinum toxin. J Am Acad Dermatol 2004; 51: 739-45
128. Product monograph: Botox (botulinum toxin type A) purified neurotoxin complex. Irvine (CA): Allergan, Inc., 2004
129. Moreau SM, Cauhepe C, Magues JP, et al. A double-blind, randomized, comparative study of Dysport vs. Botox in primary palmar hyperhidrosis. Br J Dermatol 2003; 149: 1041-5
130. Baumann L, Slezinger A, Halem M, et al. Double-blind, randomized, placebo-controlled pilot study of the safety and efficacy of Myobloc (botulinum toxin type B) for the treatment of palmar hyperhidrosis. Dermatol Surg 2005; 31 (3): 263-70
131. Baumann L, Slezinger A, Halem M, et al. Pilot study of the safety and efficacy of Myobloc (botulinum toxin type B) for treatment of axillary hyperhidrosis. Int J Dermatol 2005; 44: 418-24
132. Dressler D, Saberi FA, Benecke R. Botulinum toxin type B for treatment of axillar hyperhidrosis. J Neurol 2002; 249: 1729-32
133. Hecht MJ, Birklein F, Winterholler M. Successful treatment of axillary hyperhidrosis with very low doses of botulinum toxin B: a pilot study. Arch Dermatol Res 2004; 295: 318-9
134. Nelson L, Bachoo P, Holmes J. Botulinum toxin type B: a new therapy for axillary hyperhidrosis. Br J Plast Surg 2005; 58: 228-32
135. Lim ECH, Seet RCS, Chow A, et al. Topical botulinum toxin to treat hyperhidrosis? No sweat! Med Hypotheses 2006; 67: 27-32
136. Glogau RG. Topically applied botulinum toxin type A for the treatment of primary axillary hyperhidrosis: results of a randomized, blinded, vehicle-controlled study. Dermatol Surg 2007; 33 (1 Spec No.): S76-80
137. Kavanagh GM, Oh C, Shams K. Botox delivery by iontophoresis. Br J Dermatol 2004; 15: 1093-5
138. Odderson IR. Long-term quantitative benefits of botulinum toxin type A in the treatment of axillary hyperhidrosis. Dermatol Surg 2002; 28 (6): 480-3
139. Schnider P, Binder M, Kittler H, et al. A randomized, double-blind, placebo-controlled trial of botulinum A toxin for severe axillary hyperhidrosis. Br J Dermatol 1999; 140: 677-80
140. Wollina U, Karamfilov T, Konrad H. High-dose botulinum toxin type A therapy for axillary hyperhidrosis markedly prolongs the relapse-free interval. J Am Acad Dermatol 2002; 46 (4): 536-40
141. Salmanpoor R, Rahmanian MJ. Treatment of axillary hyperhidrosis with botulinum-A toxin. Int J Dermatol 2002; 41: 428-30
142. Whatling PJ, Collin J. Botulinum toxin injection is an effective treatment for axillary hyperhidrosis. Br J Surg 2001; 88: 814-5
143. Heckmann M, Breit S, Ceballos-Baumann AO, et al. Side-controlled intradermal injection of botulinum toxin A in recalcitrant axillary hyperhidrosis. J Am Acad Dermatol 1999; 41: 987-90
144. Heckmann M, Plewig G. Low-dose efficacy of botulinum toxin A for axillary hyperhidrosis. Arch Dermatol 2005; 141: 1255-9
145. Galadari I, Alkaabi J. Botulinum toxin in the treatment of axillary hyperhidrosis. Skinmed 2003; 2: 209-11
146. Lowe NJ, Glaser DA, Eadie N, et al. Botulinum toxin type A in the treatment of primary axillary hyperhidrosis: a 52-week multicenter double-blind, randomized, placebo-controlled study of efficacy and safety. J Am Acad Dermatol 2007; 56 (4): 604-11
147. Lowe PL, Cerdan-Sanz S, Lowe NJ. Botulinum toxin type A in the treatment of bilateral primary axillary hyperhidrosis: efficacy and duration with repeated treatments. Dermatol Surg 2003; 29 (5): 545-8
148. Bechara FG, Sand M, Altmeyer P, et al. Skin cooling for botulinum toxin A injection in patients with focal axillary hyperhidrosis. Ann Plast Surg 2007; 58 (3): 299-302
149. Pearson IC, Cliff S. Botulinum toxin type A treatment for axillary hyperhidrosis: a comparison of intradermal and subcutaneous injection techniques. Br J Dermatol 2004; 151 Suppl. 68: 95
150. Krogstad A-L, Skymne A, Pegenius G, et al. No compensatory sweating after botulinumtoxin treatment of palmar hyperhidrosis. Br J Dermatol 2005; 152: 329-33
151. Naumann M, Hamm H, Kinkelin I, et al. Botulinum toxin type A in the treatment of focal, axillary and palmar hyperhidrosis and other hyperhidrotic conditions. Eur J Neurol 1999; 6 Suppl. 4: S111-5
152. Perez-Bernal AM, Avalos-Peralta P, Moreno-Ramirez D, et al. Treatment of palmar hyperhidrosis with botulinum toxin type A: 44 months of experience. J Cosmet Dermatol 2005; 4: 163-6
153. Wollina U, Karamfilov T. Botulinum toxin A for palmar hyperhidrosis. J Eur Acad Dermatol Venereol 2001; 15: 555-8
154. Caro S, Brin M, Kaufmann H. Treatment of palmar hyperhidrosis with botulinum toxin. Clin Auton Res 1996; 6: 301
155. Glogau RG. Hyperhidrosis and botulinum toxin A: patient selection and techniques. Clin Dermatol 2004; 22: 45-52
156. Swartling C, Farnstrand C, Abt G, et al. Side-effects of intradermal injections of botulinum A toxin in the treatment of palmar hyperhidrosis: a neurophysiological study. Eur J Neurol 2001; 8: 451-6
157. Naumann M, Bergmann I, Hofmann U, et al. Botulinum toxin for focal hyperhidrosis: technical considerations and improvements in application. Br J Dermatol 1998; 139 (6): 1123-4
158. O'Riordan JM, Fitzgerald E, Gowing C, et al. Topical local anaesthetic (tetracaine) reduces pain from botulinum toxin injections for axillary hyperhidrosis. Br J Surg 2006; 93: 713-4
159. Smith KC, Comite SL, Storwick GS. Ice minimizes discomfort associated with injection of botulinum toxin type A for the treatment of palmar and plantar hyperhidrosis. Dermatol Surg 2007; 33 (1 Spec No.): S88-91
160. Baumann L, Frankel S, Welsh E, et al. Cryoanalgesia with dichlorotetrafluoroethane lessens the pain of botulinum toxin injections for the treatment of palmar hyperhidrosis. Dermatol Surg 2003; 29 (10): 1057-60
161. Kontochristopoulos G, Gregoriou S, Zakapoulou N, et al. Cryoanalgesia with dichlorotetrafluoroethane spray versus ice packs in patients treated with botulinum toxin-A for palmar hyperhidrosis: self-controlled study. Dermatol Surg 2006; 32: 873-4
162. Fujita M, Mann T, Mann O, et al. Surgical pearl: use of nerve blocks for botulinum toxin treatment of palmar-plantar hyperhidrosis. J Am Acad Dermatol 2001; 45: 587-9
163. Hayton MJ, Stanley JK, Lowe NJ. A review of peripheral nerve blockade as local anaesthesia in the treatment of palmar hyperhidrosis. Br J Dermatol 2003; 149: 447-51
164. Trindade de Almeida AR, Kadunc BV, Martins de Oliveira EM. Improving botulinum toxin therapy for palmar hyperhidrosis: wrist block and technical considerations. Dermatol Surg 2001; 27 (1): 34-6
165. Campanati A, Lagalla G, Penna L, et al. Local neural block at the wrist for treatment of palmar hyperhidrosis with botulinum toxin: technical improvements. J Am Acad Dermatol 2004; 51: 345-8
166. Blaheta HJ, Vollert B, Zuder D, et al. Intravenous regional anesthesia (Bier's block) for botulinum toxin therapy of palmar hyperhidrosis is safe and effective. Dermatol Surg 2002; 28: 666-72
167. Vollert B, Blaheta HJ, Moehrle R, et al. Intravenous regional anaesthesia for treatment of palmar hyperhidrosis with botulinum toxin type A. Br J Dermatol 2001; 144 (3): 632-3
168. Benohanian A. Surgical pearl: use of needle-free anesthesia in the treatment of palmar hyperhidrosis with botulinum A toxin. J Am Acad Dermatol 2005; 52: 1073-4
169. Smith KC, Comite SL, Balasubramanian S, et al. Vibration anesthesia: a noninvasive method of reducing discomfort prior to dermatologic procedures. Dermatol Online J 2004; 10 (2): 1
170. Vadoud-Seyedi J. Treatment of plantar hyperhidrosis with botulinum toxin type A. Int J Dermatol 2004; 43: 969-71
171. Vadoud-Seyedi J, Simonart T, Heenen M. Treatment of plantar hyperhidrosis with Dermojet injections of botulinum toxin. Dermatology 2000; 201: 179
172. Sevim S, Dogu O, Kaleagasi H. Botulinum toxin-A therapy for palmar and plantar hyperhidrosis. Acta Neurol Belg 2002; 102: 167-70
173. Campanati A, Bernardini ML, Gesuita R, et al. Plantar focal idiopathic hyperhidrosis and botulinum toxin: a pilot study. Eur J Dermatol 2007; 17 (1): 52-4
174. Kinkelin I, Hund M, Naumann M, et al. Effective treatment of frontal hyperhidrosis with botulinum toxin A. Br J Dermatol 2000; 143: 824-7
175. Barankin B, Wasel N. Treatment of inguinal hyperhidrosis with botulinum toxin type A. Int J Dermatol 2006; 45: 985-6
176. Bechara FG, Sand M, Achenbach RK, et al. Focal hyperhidrosis of the anal fold: successful treatment with botulinum toxin A. Dermatol Surg 2007; 33: 924-7
177. Wollina U, Konrad H. Botulinum toxin A in anal fissures: a modified technique. J Eur Acad Dermatol Venereol 2002; 16: 469-71
178. Pena NA, Alam M, Yoo SS. Complications with the use of botulinum toxin type A for cosmetic applications and hyperhidrosis. Semin Cutan Med Surg 2007; 26: 29-33
179. Emmerson J. Botulinum toxin for spasmodic torticollis in a patient with myasthenia gravis. Mov Disord 1994; 9: 367
180. Iwase T, Iwase C. Systemic effect of local and small-dose botulinum toxin injection to unmask subclinical myasthenia gravis. Graefes Arch Clin Exp Ophthalmol 2006; 244: 415-6
181. Erbguth F, Claus D, Engelhardt A, et al. Systemic effect of local botulinum toxin injections unmasks subclinical Lambert-Eaton myasthenic syndrome. J Neurol Neurosurg Psychiatry 1993; 56 (11): 1235-6
182. Goncalves MR, Barbosa ER, Zambon AA, et al. Treatment of cervical dystonia with botulinum toxin in a patient with myasthenia gravis. Arg Neuropsiquiatr 1999; 57 (3A): 683-5
183. Fasano A, Bentivoglio AR, Ialongo T, et al. Treatment with botulinum toxin in a patient with myasthenia gravis and cervical dystonia. Neurology 2005; 64 (12): 2155-6
184. Scott AB. Clostridial toxins as therapeutic agents. In: Simpson LL, editor. Botulinum neurotoxin and tetanus toxin. New York: Academic Press, 1989: 399-412
185. Thomas I, Brown J, Vafaie J, et al. Palmoplantar hyperhidrosis: a therapeutic challenge. Am Fam Physician 2004; 69 (5): 1117-20
186. de Almeida ART, Kadunc BV, de Oliveira EMM. Improving botulinum toxin therapy for palmar hyperhidrosis: wrist block and technical considerations. Dermatol Surg 2001; 27 (1): 34-6
187. Kwiat DM, Bersani TA, Bersani A. Increased patient comfort utilizing botulinum toxin type A reconstituted with preserved versus nonpreserved saline. Ophthal Plast Reconstr Surg 2004; 20 (3): 186-9
188. van Laborde S, Dover JS, Moore M, et al. Reduction in injection pain with botulinum toxin type B further diluted using salinewith preservative: a double-blind, randomized controlled trial. J Am Acad Dermatol 2003; 48 (6): 875-7
189. Glaser DA, Hebert AA, Pariser DM, et al. Palmar and plantar hyperhidrosis: best practice recommendations. Cutis 2007; 79 Suppl. 5: 18-28
190. Jain S. A new multiple site marking grid for botulinum toxin application in the treatment of axillary hyperhidrosis. Br J Dermatol 2006; 154: 375-6
191. Karamfilov T, Konrad H, Karte K, et al. Lower relapse rate of botulinum toxin A therapy for axillary hyperhidrosis by dose increase. Arch Dermatol 2000; 136: 487-90
192. Goodman G. Diffusion and short-term efficacy of botulinum toxin A after the addition of hyaluronidase and its possible application for the treatment of axillary hyperhidrosis. Dermatol Surg 2003; 29: 533-8