Durability of Botulinum Toxin Treatment for Axillary Hyperhidrosis

• Published in: European journal of vascular and endovascular surgery Vol. 38; no. 2; pp. 188 - 191
• Main Authors: Moffat, C.E, Hayes, W.G, Nyamekye, I.K
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-08-2009
• Subjects: Adolescent; Adult; Axillary hyperhidrosis; Botulinum toxin; Botulinum Toxins, Type A - administration & dosage; Drug Administration Schedule; Female; Follow-Up Studies; Humans; Hyperhidrosis - drug therapy; Injections, Intradermal; Kaplan-Meier Estimate; Male; Middle Aged; Neuromuscular agents; Neuromuscular Agents - administration & dosage; Severity of Illness Index; Surgery; Time Factors; Treatment Outcome; Young Adult; Injections/intradermal; Botulinum toxin; Neuromuscular agents; Axillary hyperhidrosis
• ISSN: 1078-5884; 1532-2165
• DOI: 10.1016/j.ejvs.2009.03.016

Abstract Objectives Botulinum toxin injection effectively treats axillary hyperhidrosis. Durability estimates of 3–14 months, based on self re-referral may overestimate duration. Our objective was to determine treatment durability by active follow-up of patients. Design Audit of current practice. Materials and methods Patients presenting with severe primary axillary hyperhidrosis were actively followed up for 24 months after intradermal injections of Botulinum Toxin A (Dysport™ 120 units/axilla). A 10-point Likert Scale (1 = worst imaginable symptoms, 10 = absolute resolution) and the Hyperhidrosis Disease Severity Score (HDSS) were used at 1 day and 3, 6, 12 and 24 months. We offered re-treatment when symptoms returned to the pre-intervention state. Results We treated 45 patients with a mean age of 29 (15–49) years of whom 36 (78%) were women. The median pre-treatment Likert score (i.q.r.) of 3 (2–3) improved to 10 (10–10) on day 1. Scores at 3 ( n = 44), 6 ( n = 43) and 12 ( n = 39) months were 10 (10–10), 8 (7.5–10), and 7 (5–8) respectively. The median 24-month score was 3 (3–6) for 35 patients, including 11 patients with scores ≥6 who have not required re-treatment. HDSS scores followed a similar pattern. Conclusions Axillary botulinum toxin treatment is durable. Patients experience gradual return of symptoms between 6 and 24 months. A minority do not require re-treatment at this time.