Clinical Health Updates

Botulinum toxin A effective for axillary hyperhidrosis

Clinical Question:
Are botulinum toxin type A injections safe and effective in the management of adults with axillary hyperhidrosis?

Bottom Line:
Botulinum toxin type A (Botox) injections are safe and effective for the treatment of adults with axillary hyperhidrosis. The duration of effect in this study was approximately 200 days.

Lowe NJ, Glaser DA, Eadie N, et al, for the North American Botox in Primary Axillary Hyperhidrosis Clinical Study Group. Botulinum toxin type A in the treatment of primary axillary hyperhidrosis: A 52-week multicenter double-blind, randomized, placebo-controlled study of efficacy and safety. J Am Acad Dermatol 2007;56:604-611.

Study Design:
Randomized controlled trial (double-blinded)

The long-term effects of botulinum toxin type A (BoNTA) on the global impairment associated with severe primary axillary hyperhidrosis have not been comprehensively assessed relative to placebo. The authors assessed the efficacy and safety of 2 dosages of BoNTA compared with placebo in subjects with primary axillary hyperhidrosis. Subjects (N = 322) were randomized to the use of BoNTA (75 U or 50 U/axilla) or placebo in this 52-week, multicenter, double-blind study. BoNTA treatment significantly reduced daily activity limitations at 4 weeks after injection. A 2-point improvement on the 4-point Hyperhidrosis Disease Severity Scale (HDSS) was reported in 75% of subjects in the 75-U and 50-U BoNTA groups and in 25% of the placebo group (P < .001). Improvements in HDSS scores were corroborated by gravimetric results. The median duration of effect was 197 days, 205 days, and 96 days in the 75-U, 50-U, and placebo groups, respectively. BoNTA was well tolerated.
LIMITATIONS: The effect of total surface area involvement on treatment efficacy was not evaluated.