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Related Experiment Video

Updated: Jul 14, 2026

Quantitative Autonomic Testing

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Published on: July 19, 2011

Botulinum toxin A for axillary hyperhidrosis (excessive sweating).

M Heckmann¹, A O Ceballos-Baumann, G Plewig

¹Department of Dermatology, Ludwig-Maximilians-Universität, Munich, Germany. heckmann@derma.med.uni-muenchen.de

The New England Journal of Medicine

|February 15, 2001

Summary

Botulinum toxin A injections significantly reduce excessive underarm sweating in patients with hyperhidrosis. This treatment is well-tolerated and highly recommended by patients, offering an effective solution for severe cases.

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Area of Science:

Dermatology
Neurology
Pharmacology

Background:

Primary focal hyperhidrosis often presents treatment challenges.
Botulinum toxin A inhibits acetylcholine release, crucial for sweat gland sympathetic neurotransmission.

Purpose of the Study:

To evaluate the efficacy and safety of botulinum toxin A for axillary hyperhidrosis.
To compare botulinum toxin A treatment with placebo in patients unresponsive to topical therapies.

Main Methods:

A multicenter, randomized, double-blind trial involving 145 patients with axillary hyperhidrosis.
Botulinum toxin A (200 U) was injected into one axilla, with placebo in the other. Subsequent treatment with 100 U was given to the placebo axilla.
Sweat production was measured using gravimetry.

Main Results:

Botulinum toxin A significantly reduced sweat production compared to placebo (24 mg/min vs. 144 mg/min, P<0.001) two weeks post-injection.
A further 100 U injection into the placebo axilla also significantly reduced sweat production (32 mg/min, P<0.001).
Reduced sweat rates persisted for 24 weeks, with high patient satisfaction (98% recommendation rate).

Conclusions:

Intradermal botulinum toxin A is an effective and safe treatment for severe axillary hyperhidrosis.
The therapy demonstrates a favorable safety profile and high patient-reported satisfaction.