Botulinum Toxin Type A and B Improve Quality of Life in Patients with Axillary and Palmar Hyperhidrosis

Hyperhidrosis is a common disorder that may have a severe impact on quality of life. The aim of this study was to investigate the clinical effect of two novel botulinum toxins, Xeomin (R), a type A botulinum toxin, and Neurobloc (R), a type B botulinum toxin, in the treatment of axillary and palmar hyperhidrosis. A total of 84 patients, 58 with axillary and 26 with palmar hyperhidrosis, were included in this open study. Axillae were injected with 107 +/- 22 U Xeomin (R) and palms were injected with 213 +/- 19 U Xeomin (R) and 264 +/- 60 U Neurobloc (R) over the thenar eminences to avoid muscle weakness. At follow-up 3 weeks post-treatment, all patients treated for axillary hyperhidrosis reported satisfaction in self-ranking, evaporation decreased >40%, and Dermatology Life Quality Index (DLQI) score improved from 12.0 to 1.7 (p<0.05). In the palmar group 95% were satisfied, evaporation decreased >50% and DLQI score improved from 10.3 to 1.2 (p<0.05). Only one patient in the palmar group experienced muscle weakness. In conclusion, Xeomin (R) has an excellent effect on axillary hyperhidrosis and in combination with Neurobloc (R) on palmar hyperhidrosis. Neurobloc (R) may be an option for use in the treatment of palmar hyperhidrosis in order to minimize muscular side-effects.