Section : Articles

Palmar Hyperhidrosis treatment with Botulinum Toxin: effects last longer when injections are repeated

Duration of efficacy increases with the repetition of botulinum toxin A injections in primary palmar hyperhidrosis: a study of 28 patients.

Lecouflet M, Leux C, Fenot M, Célerier P, Maillard H.

J Am Acad Dermatol. 2014 Jun;70(6):1083-7. doi: 10.1016/j.jaad.2013.12.035. Epub 2014 Mar 12.

  • Excessive sweating of the palms or Palmar Hyperhidrosis is a psychologically devastating condition and individuals affected by this are often ready to try many treatments. Treatments include aluminium cristals, ionophoresis, and thoracic sympathectomy. This last treatment is irreversible and side effects can include compensatory hyperhidrosis in other areas. Before this, botulinum toxin injections can be tried.
  • Botulinum toxin has been used for the treatment of wrinkles but thanks to action on muscle contraction. It inhibits the release of toxins (acetylcholine) and thus the contraction signal cannot be transmitted to the smooth muscle, therefore there is no contraction enabling the release of sweat. The action of Botulinum Toxin is reversible and its effects tend to last between 5 to 7 months.
  • Botulinum toxin injections have been used in the treatment of axillary hyperhidrosis. This treatment is painful but not as much as injections on the hands for palmar hyperhidrosis. Because of this treatments tend to be avoided but patients may be happy to learn that treatments last longer over repeated injections.
  • In this study from 2001 to 2012, 12 patients were treated with 250 units  of botulinum toxin A. Results show that the duration of efficacy was 7 months after the first injection treatment session and 9.5 months for the last.

Contributors Dr Christophe Hsu – dermatologist. Geneva, Switzerland