Treatment of axillary hyperhidrosis by chemodenervation of sweat glands using botulinum toxin type A

Primary axillary hyperhidrosis is a medical condition characterized by excessive underarm sweating that is thought to result from localized hyperstimulation of sweat glands by cholinergic sympathetic nerve fibers. It can be associated with significant professional, physical, and emotional impairment as well as considerable difficulties in social situations and in personal relationships. Available therapies have been limited by short-lived effectiveness and in some cases significant adverse effects that can put patients at risk for potentially serious complications. Chemodenervation of sweat glands using botulinum toxin type A (BTX-A), which has long-lasting therapeutic efficacy with minimal adverse effects, has emerged as a unique therapy for treating primary axillary hyperhidrosis. This article reviews the chemodenervation procedure, including patient preparation, BTX-A administration, and patient assessment and follow-up.