Botulinum Toxin in Treatment of Hyperhidrosis

primary hyperhidrosis is a common disorder that can causeserious social, psychological, and occupational problems. It is estimated to affect 0.6-1.0% of the population. Primary hyperhidrosismay be defined as excessive, uncontrollable sweating in the absence of adiscernible cause, and it is most commonly limited to the axillae, palms,or soles. While secondary hyperhidrosis occurs as a disorder resultingfrom certain diseases like diabetes mellitus or as a side effect of somedrugs like fluoxetine and ibuprofen.Recently, botulinum toxins are used in the field of treatment ofprimary hyperhidrosis. Botulinum toxins are a family of neurotoxinsproduced by the anaerobic bacteria Clostridium botulinum. The most usedtype among them is botulinum toxin-A which has been used in clinicalmedicine for several applications. Botulinum toxin-A acts primarily atperipheral cholinergic synapses, inhibiting the release of acetylcholine. Itstherapeutic effect was used initially to block the neuromuscular junctionin order to relieve increased muscle tone. In the last few years, theblocking action of BTX-A on cholinergically innervated sweat glands hasbeen used to treat patients with focal hyperhidrosis of the axillae andpalms. BTX-A is commercially available in two forms; Botox® andDysport®.In this thesis, we used Botox vial in the treatment of palmar andaxillary hyperhidrosis. Four patients (2 palmar & 2 axillary) participatedin this study, they were injected with Botox intradermally in anapproximate total dose of 60U-70U per palm and 30U-40U per axilla.