Efficacy of botulinum toxin type A in hyperhidrosis

Abstract

Hyperhidrosis is known as an excessive and uncontrollable sweating induced by sympathetic hyperactivity. This disease may cause social, psychological and occupational problems. Conventional treatments that uses iontoforesis, sympathectomy, antiperspirants are not effective on several cases or risky. Botulinum toxin type A appeared as a secure and efficient treatment against hyperhidrosis. It blocks acetylcholine release from presynaptic membranes. This article reviews critically the literature about this topic. The results come from six trials made with patients that had hyperhidrosis. The percentile of sweating reduction was 86% in the study made by Heckmann et al. (2001), 69,1% in Kinkelin's et al. study, 63,7% in Heckmann's et al. study (1999), and 69% in the study made by Solomon et al. Few side effects were related, they are pain during application, weakness on thumb and forehead muscles. Treatment of palmoplantar, axillary and frontal hyperhidrosis with botulinum toxin has been safe, effective, and patients return to normal activity the same day. The treatment is very expensive, limiting its use.