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Treatment of Axillary Hyperhidrosis with Botulinum Toxin: The Effect of Repeated Injections on Treatment Intervals
Melissa A. Doft, MD, Jeffrey A. Ascherman, MD.
New York-Presbyterian Hospital, New York, NY, USA.

Purpose: Axillary hyperhidrosis is a debilitating disease which affects the social and occupational lives of many Americans. It can be treated with subdermal injections of botulinum toxin. The purpose of this study was to determine the interval between injections during which patients are symptom free and if that interval varies depending on the number of treatments a patient has received.
Methods: All patients treated by the senior author with botulinum toxin for axillary hyperhidrosis between 2004 and 2010 were enrolled in the study. Patient responses to the treatment with regard to both satisfaction and length of symptom free interval were analyzed. An in depth PubMed search was done through July 2010 to compile the published data on using botulinum toxin injections to treat axillary hyperhidrosis. This data served as a benchmark to which the trends at our institution were compared.
Results: Fifty-three patients, who underwent a total of 220 axillary injection procedures,were included in the study. The average age was 29 years, and 64% were female. Twenty-three patients (43%) underwent multiple (range of 2-9) injections of botulinum toxin. The average symptom free interval was 261 days. There was no statistically significant difference in symptom free intervals after multiple treatments. Patient satisfaction rates were very high, similar to the high degrees of satisfaction found in published data.
Conclusions: Botulinum toxin injections provide an effective treatment for axillary hyperhidrosis with a rapid onset and high patient satisfaction. Many patients have a symptom free interval of 6 to 9 months following each botulinum toxin injection. This interval does not change significantly after multiple treatments.


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