Botulinum Toxin for Hyperhidrosis in the Axillary Area
Axillary hyperhidrosis (AH) impacts social and occupational lives of lots of people in all continents, and its real incidence probably is underestimated. Botulinum toxin is a safe and effective treatment option for axillary hyperhidrosis. Although its pathophysiology is not very clear, with some controversial topics, so far the beneficial effect of neuromodulators in inhibiting localized sweating temporarily is well known.
Before the procedure, the correct identification of the affected area is mandatory. The objective is to enhance efficacy avoiding drug waste or leaving areas without treatment, because the hyperhidrotic location does not always match the hairy axillary region.
Handling this medication, including dilution and injection techniques, depends on medical experience and may have some variations, including methods to make the procedure as painless as possible. Evidence supports a Level A recommendation for BoNT-A for axillary hyperhidrosis.
KeywordsAxillary hyperhidrosis Excessive underarm sweating Botox Botulinum toxin Neuromodulators
- Brehmer F, Lockmann A, Grönemeyer LL, Kretschmer L, Schön MP, Thoms KM. Repetitive injections of botulinum toxin A continuously increase the duration of efficacy in primary axillary hyperhidrosis: a retrospective analysis in 101 patients. J Dtsch Dermatol Ges. 2015;13(8):799–805.PubMedGoogle Scholar
- Glogau R, Blitzer A, Brandt F, Kane M, Monheit GD, Waugh JM. Results of a randomized, double-blind, placebo-controlled study to evaluate the efficacy and safety of a botulinum toxin type A topical gel for the treatment of moderate-to-severe lateral canthal lines. J Drugs Dermatol. 2012;11(1):38–45.Google Scholar
- Kalner IJ. Same-patient prospective comparison of Botox versus Dysport for treatment of primary axillary hyperhidrosis and review of literature. J Drugs Dermatol. 2011;10(9):1013–5.Google Scholar
- Mota JJ, Sotto MN. Anatomy and histology of sweat glands. In: Almeida ART, Hexsel DM. editors. Hyperhidrosis and botulinum toxin, vol. 1. Edition of authors. São Paulo; 2004. p. 3–6.Google Scholar