Botulinum toxin in the treatment of focal hyperhidrosis

Focal hyperhidrosis is excessive sweating affecting approximately 2–3% of the population. The condition is mainly confined to axillary and palmoplantar regions and treatment is still a challenge. Conventional treatment options, such as topical antiperspirant agents, systemic anticholinergics or iontophoresis, do not usually provide satisfactory results. Although surgical techniques are effective, they are not always practical to perform and carry the risk of surgical complications. Botulinum toxin therapy, which acts by blocking acetylcholine release during nerve stimulation, has become one of the most favorable therapies for hyperhidrosis within recent years, with effective and safe results. This paper highlights the main issues regarding the use of botulinum toxin therapy in the treatment of hyperhidrosis by reviewing the literature and the authors’ own experiences.