Muscle weakness in treatment of palmar hyperhidrosis with botulinum toxin type a: can it be prevented?

Palmar hyperhidrosis is a chronic disorder, resistant to conventional treatment. Clinical studies suggest the effectiveness of botulinum toxin A in the treatment of primary palmar hyperhidrosis.

To evaluate the efficacy of botulinum toxin A in the therapy of palmar hyperhidrosis and the frequency of incurred muscle weakness.

Four hundred seventy-four patients with palmar hyperhidrosis were enrolled in the study. The Hyperhidrosis Disease Severity Scale (HDSS) and the Minor-iodine starch test were chosen to assess the disease severity. In addition, a physician's global assessment scale was used to evaluate the effectiveness of the treatment with BTX-A.

There were 312 females and 162 males aged 19-48 (mean 29 years). The improvement following the injection at two weeks and at one, three, six and nine months, as evaluated by physicians, was 82%, 83%, 74%, 48% and 28%, respectively. Two hundred and seventy five patients reported local pain and muscle weakness occurred in 102 patients.

BTX-A led to the reduction of disease severity while transient side effects were reported.