Evidence-based medicine: botulinum toxin in focal hyperhidrosis

All studies performed so fr indicate that BTX-A is a safe and effective tre atment for focal hyperhidrosis of the axillae and palms, for gustatory swea ting, and for some other rare conditions associated with focal hyperhidrosi s. Based on two large well-designed, double-blind, placebo-controlled study there is class 1 evidence for the efficacy of BTX-A in axillary hyperhidro sis, and class 2 evidence for BTX-A in gustatory and palmar sweating (class ification according to the Quality Standards Subcommittee of the American A cademy of Neurology, 1994). Other indications (forehead sweating, plantar h yperhidrosis, truncal sweating) are only anecdotally reported.