BOTULINUM TOXIN - A POSSIBLE NEW TREATMENT FOR AXILLARY HYPERHIDROSIS

The inhibitor action of botulinum toxin is not limited to the neuromus cular junction. The toxin also blocks the autonomic cholinergic fibres , including the sympathetic fibres to sweat glands. We have previously demonstrated that the toxin produces localized anhidrosis. To determi ne the dosage, pattern and duration of the anhidrotic effect of botuli num toxin and to test the efficacy of axillary injections, we further studied seven healthy volunteers. Two individuals had subcutaneous inj ections of botulinum toxin (30 mouse units, Dysport(R)-Porton Products ) in the dorsum of the hand. Five healthy volunteers had 15-50 U of bo tulinum toxin A (Botox(R)) injected in one axilla. A circular area of complete anhidrosis on the dorsum of the hand was evident on day 2 and persisted for 11 months. By day 3, two of the axillae (injected with 50 U each) were totally dry and in one (injected with 30 U) the sweati ng was substantially reduced. The effect persisted for 6-8 months befo re wearing off. No effect was appreciated in two axillae (injected wit h 15 and 20 U). No significant side-effects were encountered. Subcutan eous injections of botulinum toxin causes chemodenervation of the swea t glands. In normal individuals axillary sweating can be abolished by 50 U of botulinum toxin A (Botox(R)). The results. offer a possible no vel treatment for severe cases of axillary hyperhidrosis.