Background: Primary focal
hyperhidrosis can significantly reduce quality of life. Therefore a lot of
treatment options in a range of conservative, physical and surgical techniques
are available. Objective: To assess the efficacy of an antiperspirant containing aluminum chloride
compared to a Botulinumtoxin A treatment for patients with primary focal hyperhidrosis.Methods and material: In this
randomized, single-center, half-side trail, a clinical score was done by patients and physician to
evaluate the severity of hyperhidrosis. Gravimetric tests were performed to
gather the amount of sweat per unit of time. Furthermore the efficacy was
determined using a four point questionnaire. Skin irritation was assessed by
measuring pH value and transepidermal waterloss.Results: A total of 22 patients were
enrolled. Two weeks after baseline the hyperhidrosis level was significantly
reduced (BTX-A: ﹣92.9%,
AL: 66.7%). In addition
both treatment options induced a significant reduction of sweat production (BTX-A: ﹣80.8%, AL: 68.8%). Please change in: Patients
evaluated good resp, very good efficacy for both treatment options at day 28. pH value and TEWL
never left physiological
range.Conclusion: Both
botulinum toxin A treatment and an antiperspirant containing aluminum chloride
in the evaluated galenic formulation are an effective and safe treatment option
for axillary focal hyperhidrosis.
References
[1]
F. G. Bechara, Current Treatment of Focal Hyperhidrosis,” Surgical Approaches Hautarzt, Vol. 60, No. 7, 2009, pp. 538-545. doi:10.1007/s00105-009-1717-1
[2]
F. G. Bechara, T. Gambichler, A. Bader, M. Sand, P. Altmeyer and K. Hoffmann, “Assessment of Quality of Life in Patients with Primary Axillary Hyperhidrosis Before and After Suction-Curettage,” Journal of the American Academy of Dermatology, Vol. 57, No. 2, 2007, pp. 207-212. doi:10.1016/j.jaad.2007.01.035
[3]
D. R. Strutton, J. W. Kowalski, D. A. Glaser and P. E. Stang, “US Prevalence of Hyperhidrosis and Impact on Individuals with Axillary Hyperhidrosis: Results from a National Survey,” Journal of the American Academy of Dermatology, Vol. 51, No. 2, 2004, pp. 241-248.
doi:10.1016/j.jaad.2003.12.040
[4]
R. Ramos and J. Moya, “Primary Hyperhidrosis and Anxiety: A Prospective Preoperative Survey of 158 Patients,” Archivos de Bronconeumología, Vol. 41, No. 2, 2005, pp. 88-92.
[5]
M. Amir, A. Arish and Y. Weinstein, “Impairment in Quality of Life among Patients Seeking Surgery for Hyperhidrosis: Preliminary Results,” Israel Journal of Psychiatry & Related Sciences, Vol. 37, No. 1, 2000, pp. 25-31.
[6]
W. B. Shelley and H. J. Hurley Jr., “Studies on Topical Antiperspirant Control of Axillary Hyperhidrosis,” Acta Dermato-Venereologica, Vol. 55, No. 4, 1975, pp. 241-260.
[7]
H. Bouman, “The Treatment of Hyperhidrosis of Hands and Feet with Constant Current,” American Journal of Physical Medicine & Rehabilitation, Vol. 31, No. 3, 1952, pp. 158-169.
[8]
B. Przybilla, U. Schwab, E. H?lzle and J. Ring, “Contact Sensitization to an Antiperspirant with the Active Ingredient Propantheline Bromide,” Hautarzt, Vol. 34, No. 9, 1983, pp. 459-462.
[9]
M. Hund, R. Sinkgraven and B. Rzany, “Randomized, Placebo-Controlled, Double Blind Clinical Trial for the Evaluation of the Efficacy and Safety of Oral Methantheliniumbromide (Vagantin) in the Treatment of Focal Hyperhidrosis,” Journal der Deutschen Dermatologischen Gesellschaft, Vol. 2, No 5, 2004, pp. 343-349.
doi:10.1046/j.1439-0353.2004.04765.x
[10]
K. T. Moran and M. P. Brady, “Surgical Management of Primary Hyperhidrosis,” British Journal of Surgery, Vol. 78, No. 3, 1991, pp 279-283. doi:10.1002/bjs.1800780306
[11]
E. Holzle and O. Braun-Falco, “Structural Alteractions of Axillary Eccrine Glands in Hyperhidrosis Following LongTerm Treatment with Aluminium Chloride Hexahydrate,” British Journal of Dermatology, Vol. 110, No. 4, 1984, pp. 399-403. doi:10.1111/j.1365-2133.1984.tb04653.x
[12]
E. Holzle, “Topical Pharmacological Treatment,” Current Problems in Dermatology, Vol. 30, No. , 2002, pp. 30-43.
doi:10.1159/000060693
[13]
M. Streker, T. Reuther, S. Verst and M. Kerscher, “Axillary Hyperhidrosis—Efficacy and Tolerability of an Aluminium Chloride Antiperspirant,” Hautarzt, Vol. 61, No. 2, 2010, pp. 139-144. doi:10.1007/s00105-009-1841-y
[14]
L. Baumann, A. Slezinger, M. Halem, J. Vujevich, L. K. Martin, L. Black and J. Bryde, “Pilot Study of the Safety and Efficacy of Myobloc? (Botulinum Toxin Type B) for Treatment of Axillary Hyperhidrosis,” International Journal of Dermatology, Vol. 44, No. 5 ,2005, pp. 418-424.
doi:10.1111/j.1365-4632.2004.02531.x
[15]
M. Heckmann, A. O. Ceballos-Baumann and G. Plewig, “Botulinum Toxin A for Axillary Hyperhidrosis (Excessive Sweating),” New England Journal of Medicine, Vol. 344, 2001, pp. 488-493.
doi:10.1056/NEJM200102153440704
[16]
B. Sommer and G. Sattler, “Botulinum Toxin in der Aesthetischen Medizin Blackwell Wissenschafts-Verlag,” Wien, Berlin, 2001.
[17]
N. J. Lowe, D. A. Glaser, N. Eadie, S. Daggett, J. W. Kowalski and P. Y. Lai, “North American Botox in Primary Axillary Hyperhidrosis Clinical Study Group. Botulinum Toxin Type A in the Treatment of Primary Axillary Hyperhidrosis: A 52-Week Multicenter Double-Blind, Randomized, Placebo-Controlled Study of Efficacy and Safety,” Journal of the American Academy of Dermatology, Vol. 56, No. 4,2007, pp. 604-611.
doi:10.1016/j.jaad.2007.01.009
[18]
D. Dressler, “Comparing Botox® and Xeomin® for Axillar Hyperhidrosis,” Journal of Neural Transmission, Vol. 117, No. 3, 2010, pp. 317-319.
doi:10.1007/s00702-010-0372-0
[19]
M. Naumann and N. J. Lowe, “Botulinum Toxin Type A in the Treatment of Bilateral Primary Axillary Hyperhidrosis: Randomised, Parallel Group, Double Blind, Placebo Controlled Trial,” BMJ, Vol. 323, No. 15, 2001, pp. 596-599. doi:10.1136/bmj.323.7313.596
[20]
K. O. Bushara, D. M. Park, J. C. Jones and H. S. Schutta, “Botulinum Toxin—A Possible New Treatment for Axillary Hyperhidrosis,” Clinical and Experimental Dermatology, Vol. 21, No. 4, 1996, pp. 276-8.
doi:10.1111/j.1365-2230.1996.tb00093.x
[21]
B. W?rle, S. Rapprich and M. Heckmann, “Definition and Treatment of Primary Hyperhidrosis,” Journal der Deutschen Dermatologischen Gesellschaft, Vol. 5, No. 7, 2007, pp. 625-628.
doi:10.1111/j.1610-0387.2007.06409.x
[22]
N. Skroza, N. Bernardini, G. La Torre, G. La Viola and C. Potenza, “Correlation between Dermatology Life Quality Index and Minor Test and Differences in Their Levels over Time in Patients with Axillary Hyperhidrosis Treated with Botulinum Toxin Type A,” Acta Dermatovenerologica Croatica, Vol. 19, No. 1, 2011, pp. 16-20.
[23]
M. Naumann, N. J. Lowe, C. J. Kumar, et al., “Botulinum Toxin Type A Is a Safe and Effective Treatment for Axillary Hyperhidrosis over 16 Months: A Prospective Study,” Archives of Dermatology, Vol, 139, No. 6, 2003, pp. 731-736. doi:10.1001/archderm.139.6.731
[24]
M. Heckmann and G. Plewig, “Hyperhidrosis Study Group. Low-Dose Efficacy of Botulinum Toxin A for Axillary Hyperhidrosis: A Randomised, Side-by-Side, Open-Label Study,” Archives of Dermatology, Vol. 141, No. 10, 2001, pp. 1255-1259.
doi:10.1001/archderm.141.10.1255
[25]
K. H. Flanagan, R. King and D. A. Glaser, “Botulinum Toxin Type a Versus Topical 20% Aluminum Chloride for the Treatment of Moderate to Severe Primary Focal Axillary Hyperhidrosis,” Journal of Drugs in Dermatology, Vol. 7, No. 3, 2008, pp. 221-227.
