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  • Chapter 27 - Hyperhidrosis

  • Edited by Daniel Truong, University of California, Riverside, Dirk Dressler, Hannover Medical School, Mark Hallett, National Institutes of Health (NIH), Christopher Zachary, University of California, Irvine, Mayank Pathak, Truong Neuroscience Institute
  • Book:
    Manual of Botulinum Toxin Therapy
    Published online:
    02 November 2023
    Print publication:
    23 November 2023, pp 223-229

  • Summary

    Hyperhidrosis is excessive sweating, beyond physiological needs. It may be divided into generalized and localized/focal types, and into primary/idiopathic and secondary forms. Primary axillary hyperhidrosis appears to be the most frequent type, followed by palmar hyperhidrosis and other patterns. Hyperhidrosis may negatively affect many fields of daily life to a significant extent, including emotional status, personal hygiene, work and productivity, leisure activities and self-esteem.

    When injected intra- or subdermally, botulinum neurotoxin (BoNT) blocks the release of acetylcholine from the sympathetic nerve fibers that stimulate the eccrine sweat glands and causes a localized, long-lasting but reversible abolishment of sweating. This chapter describes in detail the techniques for BoNT injection to treat primary axillary and palmar hyperhidrosis, as well as showing treatment of scalp and segmental hyperhidrosis. Techniques for assessing the degree and distribution of hyperhidrosis, the area to be treated and the degree of benefit are described.