Lower Relapse Rate of Botulinum Toxin A Therapy for Axillary Hyperhidrosis by Dose Increase

Botulinum Toxin for Hyperhidrosis

“…[46] Studies examining BTX-A therapy specifically for axillary HH have used varying doses, typically ranging between 50 and 100 U of Botox Ò per axilla. Although two uncontrolled, non-comparative studies of high-dose BTX-A (200 U of Botox Ò in each axilla) described efficacy for as long as 29 months, [140,191] most other studies suggest little significant improvement with dosing >50 U per axilla. [56,85,[144][145][146] One large randomized, double-blind, placebocontrolled, multicenter trial comparing 50 U and 75 U Botox Ò with placebo found no significant difference in the efficacy or duration of action with the higher Botox Ò dosage, and both doses were significantly better than placebo.…”

Upper thoracic sympathectomy for axillary osmidrosis or bromidrosis

“…[30][31][32][33] The medical applications were first hypothesized by Justinus Kerner around 1820 in his description of food-borne botulinum. 34 Botulinum toxin A acts by blocking the release of acetylcholine from the presynaptic terminal of the neuromuscular junction.…”

“…The effect of botulinum toxin A is dose-dependent, with higher doses producing longer remission of symptom up to 7-15 months. 33 We also studied the histological effects of botulinum toxin A in different tissues of cats by immunochemistry for neurofilament and SNAP-25. Injection of higher doses of BTA consistently had longer effect than the lower doses (data unpublished).…”

Botulinum toxin: Non-cosmetic indications and possible mechanisms of action

“…Intermediate doses of 50-100 U of Botox ® produce a duration of about 9-12 months, whereas higher doses of 200 U of Botox ® produce an anhidrotic effect in a part of patients than can last longer than 15 months. [1112]…”