Efficacy and Safety of Botulinum Toxin B in Focal Hyperhidrosis: A Narrative Review

Campanati, Anna; Diotallevi, Federico; Radi, Giulia; Martina, Emanuela; Marconi, Barbara; Bobyr, Ivan; Offidani, Annamaria

doi:10.3390/toxins15020147

Cited by 9 publications

(5 citation statements)

References 32 publications

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“…18 Botulinum toxin (BTX) acts by blocking the acetylcholine at the neuromuscular synapse, it exhibits a quicker onset of action but a shorter duration, usually patients responded to treatment until month 6. 19 We think that even though the cost of Miradry treatment is more than the rest of the modalities the long lasting or even permanent results present an advantage.…”

Section: Discussionmentioning

confidence: 99%

“…Topical anticholinergics are an emerging therapeutic class in the treatment of focal hyperhidrosis, and one study indicated that 2% glycopyrronium bromide cream is effective for 12 weeks of application in patients with axillary bromhidrosis, but one patient reported irritation at the site of application and another reported mydriasis, which resolved spontaneously 18 . Botulinum toxin (BTX) acts by blocking the acetylcholine at the neuromuscular synapse, it exhibits a quicker onset of action but a shorter duration, usually patients responded to treatment until month 6 19 . We think that even though the cost of Miradry treatment is more than the rest of the modalities the long lasting or even permanent results present an advantage.…”

Section: Discussionmentioning

confidence: 99%

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The application of microwaves in axillary hyperhidrosis: Curative effect observation of a pathological examination over 1 year

Tan,

Huang,

Liu

et al. 2023

J of Cosmetic Dermatology

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BackgroundIn Asia, axillary hyperhidrosis is a frequent problem for many people, and the consequent excessive sweating can seriously affect many aspects of daily life and even lead to mental disorders. Microwave therapy is a new, non‐invasive treatment method for axillary hyperhidrosis, whose energy and long‐term effectiveness still needs to be clinically validated.ObjectiveThe aim of this study was to evaluate the clinical efficacy, safety, histological changes, and psychological status of microwave devices in the treatment of axillary hyperhidrosis and osmidrosis.MethodWe conducted a prospective self‐controlled study in a top‐tier Chinese hospital. After a 5/5 energy treatment session, a skin biopsy was taken to observe histological changes both before and after treatment. An iodine starch test was used to determine the sweating range. We evaluated symptoms of improved efficacy using the Hyperhidrosis Disease Severity Scale (HDSS) and assessed changes in life status with the DLQI. In the case of concurrent underarm odor, odor‐5, VAS, and Young‐Jin Park grading were used to assess odor relief. The effect of odor on psychology was assessed by using a psychological status symptom checklist (scl‐90). The study period was 1 year.ResultsWe observed 20 patients in this study. Of those, 90% met the primary treatment endpoint of a decrease in axillary hyperhidrosis symptomatology to below grade 2 on the HDSS score (p < 0.001). Furthermore, 75% of patients achieved a treatment endpoint of at least 50% reduction in VAS (p < 0.001). 70% of patients achieved a treatment endpoint of at least 50% reduction in odor‐5 (p < 0.001). The iodine starch test showed that the region decreased 99% from the baseline to 12 months after follow‐up had ended (p < 0.001). Eight patients volunteered to undergo histological examination; their average light density of immunohistochemistry decreased from 1.04 (0.4–2.11) to 0.07 (0.04–0.46; p < 0.05). The immunohistochemical positive number for sweat glands was initially 104 (59.75–132.5) but was 41.5 (29.75–62) after the procedure. None of the patients experienced any serious adverse reactions.ConclusionThe treatment demonstrated high effectiveness, safety, and short‐lived adverse reactions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The application of microwaves in axillary hyperhidrosis: Curative effect observation of a pathological examination over 1 year

Tan,

Huang,

Liu

et al. 2023

J of Cosmetic Dermatology

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“…Subcutaneous neurotoxins such as botulinum toxin are especially useful for hyperhidrosis following amputation because a single treatment can last 3 to 6 months, whereas topicals must be applied multiple times per day and can be inherently irritating to the skin. 27,62 Furthermore, ablative fractional…”

Section: Postamputation Dermatologic Concernsmentioning

confidence: 99%

“…These patients consistently express feeling ostracized from their community and anxious about unemployment, leaking fluid, or odor from the wound, as well as other social stigmata. 62 Depression and anxiety can hinder a patient's ability to care for their wound and make them more susceptible to the myriad issues that can ensue.…”

Section: Postamputation Dermatologic Concernsmentioning

confidence: 99%

Wound Healing: Cellular Review With Specific Attention to Postamputation Care

Kirwin

2024

Cutis

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Wound healing in adults is a complex dynamic process that usually takes the greater part of 1 year to completely resolve and is marked by the end of scar formation.• Postamputation residual limbs are subject to mechanical and biophysical stress to which the overlying skin is not accustomed. Skin treatment aims at mitigating these stresses.• The major dermatologic barriers to successful wound healing following amputation include infection, skin breakdown, formation of chronic wounds and granulation tissue, heterotopic ossification, and hyperhidrosis.

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“…The mechanism of action of Botulinum toxin involves the inhibition of acetylcholine release at the neuromuscular junction, leading to a temporary reduction in sweating [ 11 ]. In the context of facial hyperhidrosis, BTA injections into the affected areas can significantly reduce sweat production, improving comfort and social interactions [ 12 ]. Several studies have highlighted the utility of BTA in reducing symptoms of hyperhidrosis, with a favorable safety profile [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Longitudinal Assessment of Facial Hyperhidrosis Management: Evaluating the Utility and Quality of Life Improvements following Botulinum Toxin Injection

Prodan-Barbulescu,

Castiglione,

Burtic

et al. 2024

Toxins

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Facial hyperhidrosis is a debilitating condition that can severely impact the quality of life. This study aimed to assess the long-term utility of Botulinum toxin type A therapy (BTA) for facial hyperhidrosis and its impact on quality of life over a one-year period. Conducted at the Pius Brinzeu Clinical Emergency Hospital in Timisoara, Romania, this longitudinal observational study involved 77 adult patients with primary facial hyperhidrosis. Participants received two sessions of Botulinum toxin injections (50 U IncoBTX-A each) and were evaluated at baseline, 6 months, and 12 months using the Hyperhidrosis Disease Severity Scale (HDSS), WHOQOL-BREF, Dermatology Life Quality Index (DLQI), and a bespoke survey. The study demonstrated significant reductions in HDSS scores from 3.6 ± 0.5 to 1.2 ± 0.8 post-treatment, sustained at 1.3 ± 0.6 at 12 months (p-value < 0.001). DLQI scores markedly decreased from 24.8 ± 4.2 to 6.2 ± 2.1 post-treatment, stabilizing at 6.5 ± 2.5 at 12 months (p-value < 0.001). Sweat production significantly dropped from 0.75 g ± 0.15 to 0.18 g ± 0.07 per 15 min (p-value < 0.001). WHOQOL-BREF scores improved notably in the mental domain from 66.7 ± 6.1 to 70.8 ± 5.2 at 12 months (p-value < 0.001), with physical and social domains also showing significant improvements. Correlation analysis revealed strong negative correlations between DLQI total score and HDSS (rho = −0.72, p-value < 0.001) and sweat production (rho = −0.68, p-value < 0.001). Regression analysis indicated significant predictors for DLQI total score, including HDSS (B Coefficient = −3.8, p-value < 0.001) and sweat production (B Coefficient = −2.2, p-value < 0.001). BTA therapy significantly improved the quality of life in facial hyperhidrosis patients, with lasting effects on symptom severity, sweat production, and quality of life domains. The correlation and regression analyses further substantiated the treatment’s impact on both physical and psychological aspects. These findings advocate Botulinum toxin as a viable long-term treatment for facial hyperhidrosis.

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Efficacy and Safety of Botulinum Toxin B in Focal Hyperhidrosis: A Narrative Review

Cited by 9 publications

References 32 publications

The application of microwaves in axillary hyperhidrosis: Curative effect observation of a pathological examination over 1 year

The application of microwaves in axillary hyperhidrosis: Curative effect observation of a pathological examination over 1 year

Wound Healing: Cellular Review With Specific Attention to Postamputation Care

Longitudinal Assessment of Facial Hyperhidrosis Management: Evaluating the Utility and Quality of Life Improvements following Botulinum Toxin Injection

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