Topical botulinum toxin to treat hyperhidrosis? No sweat!

Medical Hypotheses
Erle C H LimE P Wilder-Smith

Abstract

Palmar, plantar and axillary hyperhidrosis, though benign, may be burdensome and occupationally restrictive, even hazardous. Treatment modalities range from topical antiperspirants, iontophoresis, systemic medications such as anticholinergics and benzodiazepines and injections of botulinum toxin, to thoracic sympathectomy. Intradermal injections of botulinum toxin (BTX), though effective, are painful especially when multiple injections are required. Iontophoretic administration of BTX has been described, the BTX entering the eccrine sweat glands via the sweat pores and through the sweat ducts. We postulate that BTX can be administered topically, either unassisted or assisted by application of an electrical gradient, low-frequency ultrasound or excipients such as dimethylsulfoxide. We examine the rationale and feasibility for such a treatment modality and route of administration.

References

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Feb 4, 2006·Medical Hypotheses·Erle C H LimRaymond C S Seet

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Citations

Jun 19, 2008·Thoracic Surgery Clinics·Rafael Reisfeld, Karen I Berliner
May 15, 2007·Medical Hypotheses·Erle C H Lim, Raymond C S Seet
Feb 3, 2009·The British Journal of Dermatology·A Chow, E P Wilder-Smith
Apr 17, 2018·Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]·Suparuj LueangarunTherdpong Tempark
Sep 5, 2018·Pediatric Dermatology·Matthias K BernhardSteffen Syrbe
Feb 19, 2009·American Journal of Clinical Dermatology·Alexander GrunfeldNowell Solish

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