Botulinum toxin is also used to treat hyperhidrosis. It is often recommended when topical antiperspirant treatments and iontophoresis have proven ineffective, and before considering surgical treatment(1).
Summary
Botulinum toxin is a toxin produced naturally by a bacterium, Clostridium botulinum, responsible for botulism. When used in small quantities, this toxin “paralyses” the muscles on contact.
It is also used in certain diseases, and in cosmetic surgery to paralyse muscles to prevent certain wrinkles from forming.
Local injections of botulinum toxin can block the transmission of nerve information between the nerve and the sweat gland responsible for producing and eliminating sweat. Several studies(2),(3) have demonstrated the effectiveness of botulinum toxin on localized hyperhidrosis in the axillary (underarms) and palmoplantar (hands and feet) regions.
In practice, several injections are required at different sites to treat oversweating. They must be spaced 1.5 to 2 cm apart to treat the entire area. The botulinum toxin is injected into the dermis, which is a deep layer of the skin.
This approach is relatively effective, but its effects are temporary. You will need to carry out injections again to maintain the effect, every 7 to 12 months for the armpits and every 4 to 6 months for the hands(4).
(1) Lowe N, Campanati A, Bodokh I, et al. The place of botulinum toxin type A in the treatment of local hyperhidrosis. Br J Dermatol 2004;151:1115-22
(2) 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
(3) Bhidayasiri R, Truong DD. Evidence for effectiveness of botulinum toxin for hyperhidrosis. J Neural Transm (Vienna) 2008;115:641-5
(4) Stolman LP. Treatment of hyperhidrosis. Dermatologic Clinics. 1998; 16: 863-9
