BOTULINUM TOXIN TYPE A: AN EFFECTIVE, SAFE AND MINIMALLY INVASIVE TREATMENT OPTION OF AXILLARY AND PALMAR HYPERHIDROSIS
Keywords:
Axillary, Botulinum toxins, Anesthesia, HyperhidrosisAbstract
Objective: The uncontrollable and excessive sweating is basically a disorder called Hyperhydrosis. Sweating is essential for thermal regulation but significantly impacts on the emotional and professional life of the people suffering from this. The aim of the present investigation was to observe the effectiveness of botulinum toxin type A in              patients with hyperhidrosis, the incidence of the disease, duration of the results and possible adverse effects.
Methods: 27 patients with hyperhidrosis (axillary, palmar and axillary-palmar in combination) were treated with intradermal injection of botulinum toxin type A. Gender and racial compositions respectively was as follows; Male (n=17 or 63%): female (n=10 or 37%) and white (n=19 or 70%): black (n=8 or 30%). In the case of axillary hyperhidrosis, local infiltrative anesthesia with subcutaneous injections (Lidocaine 1% with adrenaline) dosed with 20-50 ml for 30-240 min duration was used while locoregional anesthesia (Lidocaine 1% without adrenaline) dosed with 2-5 ml was applied in the case of palmar hyperhidrosis. Diluted botulinum toxin was injected intradermally in an already anesthetized area. Each point was dosed with 2-4 U thus maximum total dose applied was 240 (60 x 4) for each anatomical region with hyperhidrosis (axillae and palm).
Results: Axillary-palmar clinical condition was found to be the most common incidence of the disease followed by alone axillary and isolated palmar hyperhidrosis. More than 50% drop in the quantity of the sweating was observed at the completion of one month. Relapse in 12 % cases was reported. 64% patients were found be symptom-free for 9 mo. Only one patient showed side minor and easily manageable ecchymosis at a few points of intradermal injection and bilateral paresthesia hands and fingers.
Conclusion: Botulinum toxin treatment is an effective, safe, and minimally invasive therapeutic treatment option, although it is costly. It helps enhances the quality of life of the patients and bring them out of stress, anxiety and emotional stress.
Keywords: Axillary, Botulinum toxins, Anaesthesia, Hyperhidrosis
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