Cooling by Frozen Gel Pack as Pain Relief During Treatment of Axillary Hyperhidrosis with Botulinum Toxin A Injections

Skiveren, Jette; Kjaerby, Emmy; Larsen, Heidi Nordahl

doi:10.2340/00015555-0465

Acta Derm Venereol

2008

DOI: 10.2340/00015555-0465

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Cooling by Frozen Gel Pack as Pain Relief During Treatment of Axillary Hyperhidrosis with Botulinum Toxin A Injections

Jette Skiveren¹,

Emmy Kjaerby²,

Heidi Nordahl Larsen³

Abstract: Botulinum toxin A injection is a well-described efficacious treatment for axillary hyperhidrosis. Although considered a safe treatment, many patients experience pain during injections. The purpose of the present study was to examine whether cooling by frozen gel packs applied in the axilla for 5 min before treatment could reduce pain. Thirty-six patients with axillary hyperhidrosis were included in this randomized, open-label prospective study, in which patients were their own controls. Pain was assessed befor… Show more

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Cited by 13 publications

References 24 publications

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Local procedures for axillary hyperhidrosis and osmidrosis: A systematic review of prospective and controlled clinical trials

Grove,

Henning,

Togsverd‐Bo

et al. 2024

JEADV Clinical Practice

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Axillary hyperhidrosis and osmidrosis are challenging to treat, and neither topical nor systemic drugs have provided optimal treatment outcomes. In the past decades, treatment with botulinum toxin (BTX) has gained status as the gold standard, but it has its limitations both in regard to duration as well as indication for osmidrosis, specifically. A variety of local interventions have been explored in both the surgical field and within energy‐based devices (EBDs) for alternative in‐office treatments, but a collective overview is lacking. This study sought to investigate and assess the evidence on and effect of current local procedures for axillary hyperhidrosis and osmidrosis. A systematic search for prospective and controlled clinical trials in the databases PubMed, Embase and Cochrane Library until 31 December 2023 was executed. Relevant literature was identified independently by two authors according to predefined inclusion and exclusion criteria. Fifty‐nine studies met the criteria for final inclusion, of which 46 studies were randomized controlled trials and 13 were nonrandomized trials. The included studies were classified by procedure type. Individually, a total of 28 studies investigated BTXs, 11 studies explored EBDs, while six studies reported on surgical interventions. Additionally, 14 studies evaluated alternative procedures or investigated combinations and side‐by‐side comparisons of the different procedure types. The dominant evidence on efficacy and safety was of BTX A. EBDs are increasingly being investigated with microwave thermolysis appearing to be the singular most established and scientifically well‐founded method. In the surgical field, less‐invasive methods are gaining ground. To meet the increasing demand for individualized treatment, additional high‐quality comparative studies are required for the establishment of a future variety of standard treatments.

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Local procedures for axillary hyperhidrosis and osmidrosis: A systematic review of prospective and controlled clinical trials

Grove,

Henning,

Togsverd‐Bo

et al. 2024

JEADV Clinical Practice

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Subjective Discomfort during Botulinumtoxin Injections Dependent on Injection Site and Needle Size: A Comparison Between 30G, 33G and 34G Needles

Kämmerer,

Bertlich,

Hartmann

et al. 2024

Aesth Plast Surg

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Background Botulinumtoxin application in the face is amongst the most common aesthetic procedures in the head and neck region. It also has numerous medical uses. One of the main reasons for patients to refrain from it is the subjective discomfort that is experienced during injections. Objectives The study at hand aimed to determine whether needles with 33G and 34G offer an advantage in terms of individual pain perception during botulinumtoxin injections. Methods We conducted a prospective study where patients were asked to grade subjective discomfort on a visual analogue scale for each region (forehead, glabella, temple) that was treated directly after treatment and 15 minutes after. Patients were treated with 30G, 33G or 34G needles, respectively. Results Ninety-nine patients that underwent treatment of 189 regions were included in the study. Patients were evenly distributed amongst the different needle sizes and regions. Subjective discomfort was greatest in all regions for 30G needles (3.9 ± 1.6 forehead, 4.3 ± 1.7 glabella and 4.0 ± 1.6 temple) followed by 33G (2.7 ± 1.5 forehead, 2.7 ± 1.9 glabella and 2.2 ± 1.2 temple) and 34G (1.7 ± 1.2 forehead, 1.6 ± 1.4 glabella and 1.6 ± 1.4 temple). All differences between needle size were statistically significant (p < 0.05) Conclusion 33G and 34G needles seem to offer smaller discomfort during BTX treatments of the head and neck, with 34G being superior to 33G. Level of Evidence III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266

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Effect of CoolSense and EMLA Cream on Pain During Intravenous Cannulation in Pediatric Population: A Randomized, Controlled Trial

et al. 2022

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Cooling by Frozen Gel Pack as Pain Relief During Treatment of Axillary Hyperhidrosis with Botulinum Toxin A Injections

Cited by 13 publications

References 24 publications

Local procedures for axillary hyperhidrosis and osmidrosis: A systematic review of prospective and controlled clinical trials

Local procedures for axillary hyperhidrosis and osmidrosis: A systematic review of prospective and controlled clinical trials

Subjective Discomfort during Botulinumtoxin Injections Dependent on Injection Site and Needle Size: A Comparison Between 30G, 33G and 34G Needles

Effect of CoolSense and EMLA Cream on Pain During Intravenous Cannulation in Pediatric Population: A Randomized, Controlled Trial

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