The successful use of botulinum toxin for the treatment of nasal hyperhidrosis

Geddoa, Emad; Balakumar, A. K.; Paes, T.

doi:10.1111/j.1365-4632.2008.03517.x

Cited by 5 publications

(6 citation statements)

References 8 publications

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“…A dose of 1 to 2 units per injection spaced every 0.5 to 1.0 cm, for a total dose of 10 to 20 units of ona-BoNT-A, is usually required. 11,12 Take care to avoid the lacrimal system and the nasal muscles when injecting at the lateral nasal wall, keeping injections as medial as possible. Very small aliquots should be injected superficially to help avoid muscle effects.…”

Section: Craniofacial Hyperhidrosismentioning

confidence: 99%

Botulinum Toxin for Hyperhidrosis of Areas Other than the Axillae and Palms/Soles

Glaser¹,

Galperin²

2014

Dermatologic Clinics

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Section: Craniofacial Hyperhidrosismentioning

confidence: 99%

Botulinum Toxin for Hyperhidrosis of Areas Other than the Axillae and Palms/Soles

Glaser¹,

Galperin²

2014

Dermatologic Clinics

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“…Thus, given this distance of 2 cm between injection sites, there is generally no need to make more than nine injections into the nose (Fig. 1), rather than the 20 described in the earlier article 1 . This eliminates the need for 11 painful injections.…”

mentioning

confidence: 95%

“…We refer to an article published in this journal in 2008 by Geddoa et al. 1 on the treatment of nasal hyperhidrosis with botulinum toxin type A and wish to propose some factors that should be considered with reference to the level of comfort experienced by the patient. Because the nose does not represent a large area of skin and as injections in this area are extremely painful, we have identified some methods of improving the technique described in 2008 1 …”

mentioning

confidence: 99%

Modified protocol for the application of botulinum toxin type A for hyperhidrosis of the nose

2013

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“…The DLQI was used in studies to measure quality of life on various areas of the body; studies of axillary sweating combined with other parts of the body, such as palms or feet, were most common (n = 26 54,56,69,77,101,103,106,107,114,[119][120][121]139,147,158,170,173,176,214,221,223,263,266,273,274 ). Studies were identified of the palm or palm and foot combined (n = 11 61,128,208,222,230,264,265,[269][270][271][272] ) and of other combinations including the face, palm and/or foot or generalised hyperhidrosis (n = 11 116,117,210,217,227,232,261,262,267,268,275 ).…”

Section: Review Of Quality-of-life Measures/toolsmentioning

confidence: 99%

“…The DLQI was identified in studies conducted globally, including in the UK (n = 9 103,232,261,262,267,268,275 ), the USA and Canada (n = 8 77,107,139,173,176,208,222,263 ), Italy (n = 7 101,102,106,214,223,266,272 ), Germany (n = 5 69,158,227,270,271 ), Sweden (n = 4 114,116,117,128 ), Greece (n = 3 [119][120][121] ), Ireland (n = 2 265,274 ), Iran (n = 2 170,264 ), Spain (n = 2 210,230 ), Australia (n = 1 ) or surgical reviews or reviews of surgery compared with dermatology (n = 3 147,267,273 ). The DLQI was used in studies to measure quality of life on various areas of the body; studies of axillary sweating combined with other parts of the body, such as palms or feet, were most common (n = 26 54,56,69,77,101,103,106,107,…”

Section: Review Of Quality-of-life Measures/toolsmentioning

confidence: 99%

Interventions for hyperhidrosis in secondary care: a systematic review and value-of-information analysis

Wade

Rice

Llewellyn

et al. 2017

Health Technol Assess

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BackgroundHyperhidrosis is uncontrollable excessive sweating that occurs at rest, regardless of temperature. The symptoms of hyperhidrosis can significantly affect quality of life. The management of hyperhidrosis is uncertain and variable.ObjectiveTo establish the expected value of undertaking additional research to determine the most effective interventions for the management of refractory primary hyperhidrosis in secondary care.MethodsA systematic review and economic model, including a value-of-information (VOI) analysis. Treatments to be prescribed by dermatologists and minor surgical treatments for hyperhidrosis of the hands, feet and axillae were reviewed; as endoscopic thoracic sympathectomy (ETS) is incontestably an end-of-line treatment, it was not reviewed further. Fifteen databases (e.g. CENTRAL, PubMed and PsycINFO), conference proceedings and trial registers were searched from inception to July 2016. Systematic review methods were followed. Pairwise meta-analyses were conducted for comparisons between botulinum toxin (BTX) injections and placebo for axillary hyperhidrosis, but otherwise, owing to evidence limitations, data were synthesised narratively. A decision-analytic model assessed the cost-effectiveness and VOI of five treatments (iontophoresis, medication, BTX, curettage, ETS) in 64 different sequences for axillary hyperhidrosis only.Results and conclusionsFifty studies were included in the effectiveness review: 32 randomised controlled trials (RCTs), 17 non-RCTs and one large prospective case series. Most studies were small, rated as having a high risk of bias and poorly reported. The interventions assessed in the review were iontophoresis, BTX, anticholinergic medications, curettage and newer energy-based technologies that damage the sweat gland (e.g. laser, microwave). There is moderate-quality evidence of a large statistically significant effect of BTX on axillary hyperhidrosis symptoms, compared with placebo. There was weak but consistent evidence for iontophoresis for palmar hyperhidrosis. Evidence for other interventions was of low or very low quality. For axillary hyperhidrosis cost-effectiveness results indicated that iontophoresis, BTX, medication, curettage and ETS was the most cost-effective sequence (probability 0.8), with an incremental cost-effectiveness ratio of £9304 per quality-adjusted life-year. Uncertainty associated with study bias was not reflected in the economic results. Patients and clinicians attending an end-of-project workshop were satisfied with the sequence of treatments for axillary hyperhidrosis identified as being cost-effective. All patient advisors considered that the Hyperhidrosis Quality of Life Index was superior to other tools commonly used in hyperhidrosis research for assessing quality of life.LimitationsThe evidence for the clinical effectiveness and safety of second-line treatments for primary hyperhidrosis is limited. This meant that there was insufficient evidence to draw conclusions for most interventions assessed and the cost-effectiveness analysis was restricted to hyperhidrosis of the axilla.Future workBased on anecdotal evidence and inference from evidence for the axillae, participants agreed that a trial of BTX (with anaesthesia) compared with iontophoresis for palmar hyperhidrosis would be most useful. The VOI analysis indicates that further research into the effectiveness of existing medications might be worthwhile, but it is unclear that such trials are of clinical importance. Research that established a robust estimate of the annual incidence of axillary hyperhidrosis in the UK population would reduce the uncertainty in future VOI analyses.Study registrationThis study is registered as PROSPERO CRD42015027803.FundingThe National Institute for Health Research Health Technology Assessment programme.

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The successful use of botulinum toxin for the treatment of nasal hyperhidrosis

Abstract: This treatment method for nasal hyperhidrosis is simple, well tolerated, and effective, and significantly improves the quality of life of the affected individuals.

Cited by 5 publications

References 8 publications

Botulinum Toxin for Hyperhidrosis of Areas Other than the Axillae and Palms/Soles

Botulinum Toxin for Hyperhidrosis of Areas Other than the Axillae and Palms/Soles

Modified protocol for the application of botulinum toxin type A for hyperhidrosis of the nose

Interventions for hyperhidrosis in secondary care: a systematic review and value-of-information analysis

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