Treatment of axillary hyperhidrosis with botulinum toxin: a single surgeon's experience with 53 consecutive patients

Axillary hyperhidrosis is a debilitating disease that affects the social and occupational lives of many Americans. It can be treated with subdermal injections of botulinum toxin. This study aimed to determine the interval between injections during which patients are symptom free and whether that interval varies depending on the number of treatments a patient has received.

The study enrolled all the patients treated with botulinum toxin for axillary hyperhidrosis by the senior author between 2004 and 2010. Patient responses to the treatment with regard to both satisfaction and length of the symptom-free interval were collected prospectively and analyzed. An in-depth PubMed search was performed through July 2010 to compile the published data on using botulinum toxin injections to treat axillary hyperhidrosis. These data served as a benchmark to which the trends at our institution were compared.

The 53 patients included in the study had an average age of 29 years, and 64% were women. Of the 53 patients, 23 (43%) underwent multiple injections of botulinum toxin. The average symptom-free interval was 261 days. There was no statistically significant difference in symptom-free intervals after multiple treatments. Patient satisfaction rates were very high, similar to the high degrees of satisfaction found in the published data.

Botulinum toxin injections provide an effective treatment for axillary hyperhidrosis with a rapid onset and high patient satisfaction. Many patients have a symptom-free interval of 6-9 months after each botulinum toxin injection. This interval does not change significantly after multiple treatments.