Botulinum Toxin for Hyperhidrosis Treatment Abstract Primary focal hyperhidrosis is a disorder of excessive sweating which is typically of unknown etiology. Axillae, palms, soles and face are typical area for primary focal hyperhidrosis. The disorder is often overlooked, but its effects on social and occupational lives can become a big hassle for many people in everyday life, particularly in severely affected people. This also leads to emotional and psychosocial distress. Certain treatment strategies, such as topical formaldehyde, iontophoresis and oral anticholinergics have been used in clinical practice for quite a while, yet mostly come up with adverse effects and complications that eventually unable to meet patient’s satisfaction. Nevertheless, …show more content…
The first step is to dry the affected area with an absorbent paper. Then applying a 3% to 5% iodine solution to the area and neighboring region is the next step and allowed it to dry. A dark purple color will appear in the sweat area, which is a reaction of iodine-starch and eccrine sweat. Physician should make a mark on the area of sweating before applying ice packs, as the condensation may falsely enlarge the area. Photographs of the distribution of sweating can be taken to track the patient’s response to treatment. Many physicians today use surgical preparations such as Betadine solution or swabs to perform the iodine-starch test. Decolorized iodine solution is not recommended to use in this test as it does not perform the colorimetric change …show more content…
Although two uncontrolled, non-comparative studies of high-dose BTX-A (200 U of Botox® in each axilla) described efficacy for as long as 29 months,[140,191] most other studies suggest little significant improvement with dosing >50 U per axilla.[56,85,144-146] One large randomized, double-bling, placebo-controlled, multicenter trial comparing 50 U and 75 U Botox® with placebo found no significant difference in the efficacy or duration of action with the higher Botox® dosage, and both doses were significantly better than placebo.[146] One report incurporated the use of hyaluronidase to facilitate spread and lower the overall dose of BTX-A