ABSTRACT
Hyperhidrosis is a pathology for which there was hitherto no medical treatment. The treatment of hyperhidrosis using botulinum toxin A has been carried out for nearly 10 years. Its authorization for the treatment of axillary hyperhidrosis has been obtained in many countries (England, Switzerland, New Zealand, Canada, France, Germany). The other therapeutic alternatives such as local treatments (antiperspirants, iontophoresis), oral treatments (central atropinic agents), and surgical treatments (subcutaneous curettage of sweat glands, endoscopic transthoracic sympathectomy) are little used, and are either not very effective or responsible for significant side-effects. From this point of view, treatment of hyperhidrosis by using botulinum toxin has become increasingly important. First, some physiopathogenic elements are discus-
sed, then the treatment of hyperhidrosis by botulinum toxin is evaluated. Hyperhidrosis is an excessive production of sweat
by the eccrine glands, independent of the mechanisms of thermoregulation. Palmar and axillary hyperhidrosis, because of the significant embarrassment it causes, has psychological and social repercussions and can be responsible for true socioprofessional handicaps ranging from simply refusing to shake hands, to repeatedly having to change clothes, to significant perspiration with the least emotion. It affects on average about 2.8% of the population,
beginning in childhood, involving in nearly 50% of cases the axillae and in almost 25% the palms. Recently, preliminary results from the first European hyperhidrosis epidemiology survey showed that 2.3% of subjects had a formal diagnosis of hyperhidrosis and 0.6% of respondents had focal hyperhidrosis that ‘frequently’ or ‘always’ impacted on quality of life, in the absence of known comorbidities.1
