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Techniques to Relieve Pain Associated With Botulinum Injections for Palmar and Plantar Hyperhidrosis
Sarah Nasser1, Mehdi Farshchian2, Arash Kimyai-Asadi3
1Wayne State University School of Medicine, Detroit, Michigan.
Summary
Botulinum neurotoxin (BTX) effectively treats hyperhidrosis, but injection pain is a concern. This review examines pain-reducing techniques, finding topical anesthesia, ice, and vibration safest for BTX injections.
Area of Science:
- Dermatology
- Pain Management
- Medical Treatments
Background:
- Palmar and plantar hyperhidrosis (HH) causes excessive sweating.
- Botulinum neurotoxin (BTX) is an effective treatment for HH.
- Injection pain limits patient acceptance of BTX therapy for HH.
Purpose of the Study:
- To review techniques for minimizing injection pain in palmoplantar hyperhidrosis.
- To discuss the advantages and limitations of various pain-relief modalities.
Main Methods:
- Comprehensive literature search of PubMed/MEDLINE, Embase, Cochrane Central, and Google Scholar.
- Included randomized controlled trials, cohort studies, and case series.
- Focused on techniques for pain relief during BTX injections for palmar and plantar HH.
Main Results:
- Techniques include nerve blocks, Bier blocks, cryoanalgesia, needle-free anesthesia, topical anesthetics, and vibration anesthesia.
- Each method has specific merits and drawbacks.
- Safety and convenience vary across techniques.
Conclusions:
- Topical anesthesia, ice, and vibration are the safest, most convenient noninvasive options.
- Nerve blocks, Bier block, and needle-free anesthesia offer superior pain relief but require training and equipment.
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