NEW YORK, Oct 02 (Reuters) -- Injections of botulinum A neurotoxin -- a toxin derived from bacteria and marketed under the name Botox -- can safely and effectively treat a condition called axillary hyperhidrosis, which causes profuse sweating, according to a US study.
People with axillary hyperhidrosis sweat so profusely that they can soak through a shirt within minutes.
"The finding offers patients with this condition a significant alternative to surgery," said researcher Dr. Richard Glogau, a clinical professor of dermatology at University of California, San Francisco.
"There is considerable emotional and social stigma attached to the condition," Glogau reports in the journal Dermatologic Surgery.
Axillary hyperhidrosis is usually treated with antiperspirants, drugs, or surgery -- including surgery to remove sweat glands in the arm pits. All of these treatments have limited success, however, and some cause severe side effects. Surgical removal of sweat glands can lead to a complication known as "compensatory hyperhidrosis," increased sweating elsewhere in the body.
Previous studies have found that injections of botulinum A neurotoxin -- a toxin derived from botulism bacteria -- can effectively treat palmar hyperhidrosis, which causes extremely sweaty palms. The toxin blocks the release of the neurotransmitter acetylcholine, which stimulates the sweat glands. Acetylcholine also helps control muscle movement, and the toxin is used to treat uncontrolled muscle twitches. Dermatologists also inject the toxin into forehead muscles to reduce the appearance of wrinkles.
To see whether Botox would effectively treat underarm axillary hyperhidrosis, Glogau tested it on 12 men and women with the condition. Each received injections of minute doses of the toxin in the armpits.
Within 48 hours, all patients reported that they were sweating substantially less, Glogau reports. The effects lasted an average of 5 months, at which time the injections were repeated. The repeat treatment was effective for another 5 months. No one reported compensatory hyperhidrosis or any other significant side effects.
Dermatologist should be able to complete the treatment in their office without anesthesia, Glogau told Reuters Health in an interview, "particularly if they've had some prior experience with Botox."
The one drawback, he acknowledges, is cost. Glogau estimates that each treatment will cost between $700 and $1,000.
"However, offset against the social stigma, emotional stress, and costs associated with clothing wear, repair, and cleaning, Botox appears to offer a significant and elegant therapeutic advance in the treatment of axillary hyperhidrosis," he concludes.
Botox is manufactured by Allergan Pharmaceuticals of Irvine, California.
SOURCE: Dermatologic Surgery 1998;24:817-819.
