DOUBLE-BLIND TRIAL OF BOTULINUM-A TOXIN FOR THE TREATMENT OF FOCAL HYPERHIDROSIS OF THE PALMS

We performed a randomized double-blind study within-group comparison i n 11 patients to study the effect of subcutaneous injections of botuli num A toxin in focal hyperhidrosis of the palms. A total dose of 120 m U (mouse units) of botulinum A toxin (Dysport(R)) was injected into si x different sites on one palm, whereas the other was injected with ste rile saline. Objective quantification of sweat production was performe d using digitized ninhydrin-stained sheets, Three weeks after treatmen t, the mean reduction of sweat production in the botulinum A toxin-tre ated palms was 26% (P < 0.001), after 8 weeks 26% (P = 0.002) and afte r 13 weeks 31% (P < 0.001). Subjective assessment of sweat production by the patients using a visual analogue scale showed a 38% improvement in the botulinum A toxin-treated palms at 3 weeks (P = 0.002), 40% at 8 weeks (P = 0.002) and 38% at 13 weeks (P = 0.002). Neither the obje ctive measurement nor the subjective rating showed a statistically sig nificant reduction of sweating in the placebo-treated palms. Three pat ients reported reversible minor weakness of powerful handgrip after in jection at the toxin-treated site, lasting between 2 and 5 weeks.