Prospective evaluation of the efficacy of dermal botulinium toxin for primary axillary hyperhidrosis

Background Primary axillary hyperhidrosis (PAH) is an embarassing, socially disabling condition, most commonly seen in young people. Previous treatments for this condition have included sympathectomy or axillary skin excision. Recently botulinum toxin has been used to provide effective, non-invasive treatment for this condition. Aims To investigate the effect of botulinum toxin injection in patients with PAH on sweat production and psychological wellbeing. Methods Ten patients were assessed before treatment with botulinum toxin injection using gravimetric analysis and a psychometric questionnaire. Patients were reassessed at intervals of one,four and twelve weeks following treatment. Results Injection with botulinum toxin resulted in significant improvement in patients physical symptoms and psychological wellbeing. However, improvement was short-lived with recurrence of symptoms at three months. Conclusion Botulinum toxin injection provides very effective short-term relief of PAH. While its limitations should be recognised and explained when consenting patients for treatment,this does not necessarily diminish its value in the treatment of PAH.