Hyperhidrosis
T he New Eng land Jour nal of Medicine
B OTULINUM TOXIN A FOR AXILLARY HYPERHIDROSIS (EXCESSIVE SWEATING)
MARC HECKMANN, M.D., ANDRÉS O. CEBALLOS-BAUMANN, M.D., AND GERD PLEWIG, M.D.,
FOR THE HYPERHIDROSIS STUDY GROUP*
ABSTRACT
Background Treatment of primary focal hyperhidro-
sis is often unsatisfactory. Botulinum toxin A can stop excessive sweating by blocking the release of acetylcholine, which mediates sympathetic neurotransmission in the sweat glands.
Methods We conducted a multicenter trial of botulinum toxin A in 145 patients with axillary hyperhidrosis. The patients had rates of sweat production greater than 50 mg per minute and had had primary axillary hyperhidrosis that was unresponsive to topical therapy with aluminum chloride for more than one year.
In each patient, botulinum toxin A (200 U) was injected into one axilla, and placebo was injected into the other in a randomized, double-blind manner. (The units of the botulinum toxin A preparation used in this study are not identical to those of other preparations.) Two weeks later, after the treatments were revealed, the axilla that had received placebo was injected with
100 U of botulinum toxin A. Changes in the rates of sweat production were measured by gravimetry.
Results At base line, the mean (±SD) rate of sweat production was 192±136 mg per minute. Two weeks after the first injections the mean rate of sweat production in the axilla that received botulinum toxin A was 24±27 mg per minute, as compared with 144±113 mg per minute in the axilla that received placebo
B OTULINUM TOXIN A FOR AXILLARY HYPERHIDROSIS (EXCESSIVE SWEATING)
MARC HECKMANN, M.D., ANDRÉS O. CEBALLOS-BAUMANN, M.D., AND GERD PLEWIG, M.D.,
FOR THE HYPERHIDROSIS STUDY GROUP*
ABSTRACT
Background Treatment of primary focal hyperhidro-
sis is often unsatisfactory. Botulinum toxin A can stop excessive sweating by blocking the release of acetylcholine, which mediates sympathetic neurotransmission in the sweat glands.
Methods We conducted a multicenter trial of botulinum toxin A in 145 patients with axillary hyperhidrosis. The patients had rates of sweat production greater than 50 mg per minute and had had primary axillary hyperhidrosis that was unresponsive to topical therapy with aluminum chloride for more than one year.
In each patient, botulinum toxin A (200 U) was injected into one axilla, and placebo was injected into the other in a randomized, double-blind manner. (The units of the botulinum toxin A preparation used in this study are not identical to those of other preparations.) Two weeks later, after the treatments were revealed, the axilla that had received placebo was injected with
100 U of botulinum toxin A. Changes in the rates of sweat production were measured by gravimetry.
Results At base line, the mean (±SD) rate of sweat production was 192±136 mg per minute. Two weeks after the first injections the mean rate of sweat production in the axilla that received botulinum toxin A was 24±27 mg per minute, as compared with 144±113 mg per minute in the axilla that received placebo