BOTULINUM TOXIN THERAPY FOR PALMAR HYPERHIDROSIS

Background: Severe palmar hyperhidrosis is a chronic disease, resistan t to conventional therapy. Botulinum toxin inhibits sweat production b y blocking release of acetylcholine from presynaptic membranes. Object ive: Our purpose was to evaluate the short-and long-term effectiveness of botulinum toxin therapy in treatment of palmar hyperhidrosis. Meth ods: Four patients with severe palmar hyperhidrosis were treated with subepidermal injections of botulinum toxin. Fifty injections, 2 mouse units each, were used in each palm. Regional nerve blocks of the media n and ulnar nerves were performed before the procedure. Patients were observed for 12 months after treatment. Results: Botulinum toxin injec tions significantly reduced sweat production in the treated areas of t he palms. Anhidrosis lasted for 12 months in one patient, 7 months in two patients, and 4 months in one patient. Mild weakness of the thumb lasting 3 weeks occurred in one patient. No other side effects were ob served. Conclusion: Botulinum toxin provides an effective, safe, and l ong-lasting alternative therapeutic modality for treatment of severe p almar hyperhidrosis. Additional studies are needed for optimization of the technique.