Botulinum toxin: a treatment for compensatory hyperhidrosis in the trunk

BACKGROUND: Severe compensatory hyperhidrosis (CH) in the trunk occurs after sympathectomy in some patients. Limited treatment options for these cases have been proposed, and the overall results have been disappointing, but injection of botulinum toxin-A (BTX-A) is an emerging, reliable treatment method for focal hyperhidrosis. OBJECTIVE: To demonstrate the efficacy, longevity, and safety of BTX-A injection for severe truncal sweating in CH patients who were refractory to conventional treatment. METHODS: Seventeen patients were injected with 100 to 500 U of BTX-A in the truncal area. After the follow-up period, the Hyperhidrosis Disease Severity Scale (HDSS) for efficacy and the Dermatology Life Quality Index (DLQI) were measured for improvement in patients' quality of life. RESULTS: The baseline mean HDSS score+/-standard deviation was 3.6+/-0.5, and the sweating resolved within 5 days. The effect was sustained for 2 to 8 months (4.1+/-1.5 months) and the baseline DLQI score of 9.4+/-2.0 fell to 2.8+/-1.0. No serious side effects or adverse events resulted from the treatment. CONCLUSIONS: BTX-A injection was a well-tolerated, effective, and safe method for treating severe truncal CH, although the considerable cost and limited duration of the treatment effects were major disadvantages.ope