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Campanati A, Gregoriou S, Milia-Argyti A, Kontochristopoulos G, Radi G, Diotallevi F, Martina E, Offidani A. THE PHARMACOLOGICAL TREATMENT AND MANAGEMENT OF HYPERHIDROSIS. Expert Opin Pharmacother 2022; 23:1217-1231. [PMID: 35686667 DOI: 10.1080/14656566.2022.2083499] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Idiopathichyperhidrosis is a dysfunctional disorder involving eccrine sweat glands and its impact on patients' daily quality of life is well-known. Unlike some years ago, when only poor effective and safe therapeutic alternatives were available, nowadays, several emerging pharmacological active substances have gained significant space as treatment options. AREAS COVERED The authors report on, in this narrative review, the emerging data from the literature focusing on the pharmacological treatments to draw up a drug treatments flow-chart for patients with idiopathic hyperhidrosis, taking into consideration specific differences among axillary, palmoplantar and craniofacial hyperhidrosis. EXPERT OPINION Idiopathic hyperhidrosis, regardless of the site of involvement, remains a functional disorder that places a significant burden on patients. After balancing efficacy against adverse events, systemic therapy, although off-label for all forms of hyperhidrosis can represent an additive therapeutic option for patients with insufficient response to topical treatment according to a step wise therapeutic approach. Until the pathophysiological mechanisms underlying hyperhidrosis are clear, and the etiological therapeutic approach become realistic, the greatest challenge in the therapeutic management of hyperhidrotic patients seems to be the search for the most convenient combination between different therapeutic modalities (topical and systemic agents, and botulinum toxins) to achieve long-term control of the disease symptoms.
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Affiliation(s)
- Anna Campanati
- National and Kapodistrian University of Athens, 1st department of Dermatology, Andreas Sygros Hospital.,Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic marche University, Ancona
| | - Stamatis Gregoriou
- National and Kapodistrian University of Athens, 1st department of Dermatology, Andreas Sygros Hospital.,Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic marche University, Ancona
| | - Adamantia Milia-Argyti
- National and Kapodistrian University of Athens, 1st department of Dermatology, Andreas Sygros Hospital.,Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic marche University, Ancona
| | - George Kontochristopoulos
- National and Kapodistrian University of Athens, 1st department of Dermatology, Andreas Sygros Hospital.,Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic marche University, Ancona
| | - Giulia Radi
- National and Kapodistrian University of Athens, 1st department of Dermatology, Andreas Sygros Hospital.,Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic marche University, Ancona
| | - Federico Diotallevi
- National and Kapodistrian University of Athens, 1st department of Dermatology, Andreas Sygros Hospital.,Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic marche University, Ancona
| | - Emanuela Martina
- National and Kapodistrian University of Athens, 1st department of Dermatology, Andreas Sygros Hospital.,Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic marche University, Ancona
| | - Annamaria Offidani
- National and Kapodistrian University of Athens, 1st department of Dermatology, Andreas Sygros Hospital.,Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic marche University, Ancona
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2
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Bérard M, Leducq S, Laribi K, Samaran R, Maillard H. Factors associated with efficacy of botulinum toxin A injections in primary axillary hyperhidrosis: a retrospective study of ninety patients. Dermatol Ther 2022; 35:e15620. [DOI: 10.1111/dth.15620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/12/2022] [Accepted: 06/02/2022] [Indexed: 11/29/2022]
Affiliation(s)
| | - Sophie Leducq
- Department of Dermatology and Reference Center for Rare Diseases and Vascular Malformations (MAGEC) CHRU Tours Tours France
| | - Kamel Laribi
- Department of Hematology Le Mans Hospital Le Mans France
| | - Romain Samaran
- Department of Dermatology Le Mans Hospital Le Mans France
| | - Hervé Maillard
- Department of Dermatology Le Mans Hospital Le Mans France
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3
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Hüray H, Özkoca D, Zekayi K. A Retrospective Analysis of the Uses of BoNT‐A in Daily Dermatological Practice. J Cosmet Dermatol 2022; 21:1948-1952. [DOI: 10.1111/jocd.14845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 01/17/2022] [Accepted: 02/09/2022] [Indexed: 11/29/2022]
Affiliation(s)
| | - Defne Özkoca
- İstanbul University‐Cerrahpaşa, Cerrahpaşa Medical Faculty, Department of Dermatology and Venerology
| | - Kutlubay Zekayi
- İstanbul University‐Cerrahpaşa, Cerrahpaşa Medical Faculty, Department of Dermatology and Venerology
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4
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Chen SQ, Wang TT, Zhou Y, Li W, Man XY. Comparison of Long-Term Effectiveness and Safety of Microwave and Surgery in the Treatment of Axillary Osmidrosis: A Single-Center Retrospective Study. Dermatol Surg 2022; 48:126-130. [PMID: 34856594 PMCID: PMC8667791 DOI: 10.1097/dss.0000000000003276] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND A microwave-based device is a newly developed method for treating axillary osmidrosis. Few studies have compared the difference between microwave therapy and subcutaneous curettage for axillary osmidrosis. OBJECTIVE To compare the long-term effectiveness, complications, and recurrence of osmidrosis after microwave therapy and subcutaneous curettage. METHODS AND MATERIALS Medical records of 155 patients with osmidrosis treated with microwave therapy or subcutaneous curettage were reviewed retrospectively. Demographic data, visual analog scale for odor, hyperhidrosis disease scale, complications, and recurrence were analyzed. RESULTS Osmidrosis improved significantly in both treatment groups at 6 months. Effective improvement was observed in 90% and 23% of the patients in the surgery and microwave groups, respectively, after 3 years postoperatively. The recurrence rates were 39% and 21% in the microwave and surgery groups, respectively. The transient complication rate was higher in the microwave group, and long-term complications only occurred in the surgery group. CONCLUSION Subcutaneous curettage is a more effective approach for axillary osmidrosis. However, microwave therapy is recommended for patients with cosmetic concerns.
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Affiliation(s)
- Si-Qi Chen
- All authors are affiliated with the Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ting-Ting Wang
- All authors are affiliated with the Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yuan Zhou
- All authors are affiliated with the Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wei Li
- All authors are affiliated with the Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiao-Yong Man
- All authors are affiliated with the Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Galadari H, Galadari I, Smit R, Prygova I, Redaelli A. Treatment approaches and outcomes associated with the use of abobotulinumtoxinA for the treatment of hyperhidrosis: A systematic review. J Am Acad Dermatol 2021; 85:1121-1129. [DOI: 10.1016/j.jaad.2020.07.123] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 07/20/2020] [Accepted: 07/30/2020] [Indexed: 11/30/2022]
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6
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Martina E, Diotallevi F, Radi G, Campanati A, Offidani A. Therapeutic Use of Botulinum Neurotoxins in Dermatology: Systematic Review. Toxins (Basel) 2021; 13:toxins13020120. [PMID: 33562846 PMCID: PMC7915854 DOI: 10.3390/toxins13020120] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/19/2021] [Accepted: 01/22/2021] [Indexed: 12/21/2022] Open
Abstract
Botulinum toxin is a superfamily of neurotoxins produced by the bacterium Clostridium Botulinum with well-established efficacy and safety profile in focal idiopathic hyperhidrosis. Recently, botulinum toxins have also been used in many other skin diseases, in off label regimen. The objective of this manuscript is to review and analyze the main therapeutic applications of botulinum toxins in skin diseases. A systematic review of the published data was conducted, following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Botulinum toxins present several label and off-label indications of interest for dermatologists. The best-reported evidence concerns focal idiopathic hyperhidrosis, Raynaud phenomenon, suppurative hidradenitis, Hailey–Hailey disease, epidermolysis bullosa simplex Weber–Cockayne type, Darier’s disease, pachyonychia congenita, aquagenic keratoderma, alopecia, psoriasis, notalgia paresthetica, facial erythema and flushing, and oily skin. Further clinical trials are still needed to better understand the real efficacy and safety of these applications and to standardize injection and doses protocols for off label applications.
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Axillary Botulinum Toxin Injection for the Treatment of Moderate to Severe Hyperhidrosis. JOURNAL OF THE DERMATOLOGY NURSES' ASSOCIATION 2021. [DOI: 10.1097/jdn.0000000000000594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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8
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Arif T. A simple technique to standardize the administration of botulinum toxin
type‐A
for idiopathic axillary hyperhidrosis: A preliminary report. Dermatol Ther 2020; 33:e14286. [DOI: 10.1111/dth.14286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 09/01/2020] [Accepted: 09/03/2020] [Indexed: 11/30/2022]
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9
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Five-year follow-up of patients treated with intra-dermal botulinum toxin for axillary hyperhidrosis. Ir J Med Sci 2020; 189:1023-1026. [PMID: 31898163 DOI: 10.1007/s11845-019-02131-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Accepted: 10/26/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Axillary hyperhidrosis is a common complaint affecting 5% of the general population. It can significantly impact quality of life (QOL) and may be extremely debilitating. Administration of intra-dermal botulinum toxin type-A (Botox) has been proven to be effective in managing axillary hyperhidrosis; however, to date, no long-term data has assessed its efficacy. AIM We aim to assess long-term (> 5 years) QOL outcomes in this patient cohort. METHODS In this single-centre series, all patients attending for axillary botox, with five or more years of follow-up, were prospectively included. QOL was assessed in all patients using the validated assessment tool, the modified Dermatology Life Quality Index (DLQI). Standard statistical methods were utilised with data reported as mean (± standard deviation). Subgroup analysis utilising previously published departmental data allowed for further assessment of change in QOL over time. RESULTS A total of 75 patients (83% female) met the inclusion criteria with 67% completing the DLQI assessment. Follow-up ranged from 5 to 10 years with a mean age of 37.6 years (± 8.82). The mean number of treatments over the study period was 12 (± 3.1). Mean overall post-treatment DLQI score was 1.6 (± 2.01). This represented a significant improvement in patient QOL (p = < 0.0001) associated with long-term botox application. This statistical significance was identified consistently across all components of the DLQI tool. CONCLUSION These data suggest that the established early QOL benefits associated with intra-dermal botox administration for AH are sustained in the long term. This benefit was seen across all subsets of the DLQI tool.
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10
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Nawrocki S, Cha J. Botulinum toxin: Pharmacology and injectable administration for the treatment of primary hyperhidrosis. J Am Acad Dermatol 2019; 82:969-979. [PMID: 31811879 DOI: 10.1016/j.jaad.2019.11.042] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 11/15/2019] [Accepted: 11/22/2019] [Indexed: 01/17/2023]
Abstract
Hyperhidrosis is a dermatological condition defined by excessive sweating beyond thermoregulatory needs with significant effects on patients' quality of life. Hyperhidrosis is categorized as primary or secondary: primary hyperhidrosis is mostly focal and idiopathic, whereas secondary hyperhidrosis is commonly generalized and caused by an underlying medical condition or use of medications. Various surgical and nonsurgical therapies exist for primary hyperhidrosis. Although botulinum toxin is one of the deadliest toxins known, when used in small doses, it is one of the most effective therapies for primary hyperhidrosis. Botulinum toxin injections are widely used as a second-line primary hyperhidrosis treatment option once topical treatment strategies have failed. This article provides an overview of the commercially available botulinum toxin formulations and their applications in the treatment of primary hyperhidrosis.
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Affiliation(s)
- Shiri Nawrocki
- Rutgers-Robert Wood Johnson Medical School, Department of Dermatology, Piscataway, New Jersey.
| | - Jisun Cha
- Thomas Jefferson University, Department of Dermatology, Philadelphia, Pennsylvania
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11
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Guida S, Farnetani F, Nisticò S, Giorgio Mariarosaria C, Babino G, Pellacani G, Fulgione E. New trends in botulinum toxin use in dermatology. Dermatol Pract Concept 2019. [DOI: 10.5826/10.5826/dpc.0804a05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Background: Recent studies have highlighted new botulinum neurotoxin (BoNT) applications in the field of dermatology. Objective: To review current knowledge of BoNT use in dermatology. Methods: The literature of the last 5 years has been reviewed. Results: We describe interesting protocols of BoNT treatment for hyperhidrosis (HH), hypertrophic scars and keloids, Raynaud phenomenon, facial flushing, oily skin, psoriasis, Hailey-Hailey disease, and cutaneous lesions like painful lesions and periorbital syringomas. Conclusions: Several skin conditions eligible for BoNT treatment have been described. After the wide application for HH treatment, scars as well as vascular and inflammatory skin disorders, oily skin and cutaneous lesions represent fields of application of BoNT.
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Affiliation(s)
- Stefania Guida
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Italy
| | - Francesca Farnetani
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Italy
| | - Steven Nisticò
- Department of Health Sciences, University Magna Graecia, Catanzaro, Italy
| | | | - Graziella Babino
- Department of Dermatology, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Giovanni Pellacani
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Italy
| | - Elisabetta Fulgione
- Department of Dermatology, University of Campania Luigi Vanvitelli, Naples, Italy
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12
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Rzany B, Bechara FG, Feise K, Heckmann M, Rapprich S, Wörle B. Update of the S1 guidelines on the definition and treatment of primary hyperhidrosis. J Dtsch Dermatol Ges 2019; 16:945-952. [PMID: 29989362 DOI: 10.1111/ddg.13579] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Focal hyperhidrosis can have a considerable impact on social and occupational activities and be associated with significant impairment in quality of life. Primary (idiopathic) hyperhidrosis is neither caused by systemic disorders nor by external factors. It usually occurs in areas characterized by a high density of sweat glands such as the axillae and hands. The diagnosis of focal hyperhidrosis is based on history and clinical findings. Supplementary diagnostic tests include gravimetry (measurement of the amount of sweat) and the iodine starch test (which shows the area of sweating). Treatment options consist of topical agents, botulinum toxin A injections, iontophoresis, treatment with radiofrequency, microwaves, or ultrasound as well as surgical procedures (axillary suction curettage, sympathectomy). Systemic agents such as anticholinergics may also be used. Selection of the most appropriate therapeutic approach depends on the site affected, prior treatment as well as the patient's requests.
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Affiliation(s)
- Berthold Rzany
- RZANY & HUND, Kurfürstendamm 183, 10707 Berlin, Deutschland
| | - Falk G Bechara
- Abteilung für Dermatochirurgie, Klinik für Dermatologie, Venerologie und Allergologie, Ruhr-Universität Bochum, Bochum, Deutschland
| | - Konstantin Feise
- Praxis Dr. Feise, Belegarzt Sophienklinik, Sophienstraße 41, 70178 Stuttgart, Deutschland
| | - Marc Heckmann
- Praxisklinik für Dermatologie, Kreuzstraße 26, 82319 Starnberg, Deutschland
| | - Stefan Rapprich
- Hautmedizin Bad Soden, Kronberger Straße 2, 65812 Bad Soden, Deutschland
| | - Birgit Wörle
- Dermatologie und Laserzentrum, Hirslanden Klinik Meggen, Klinik St. Anna AG, Meggen, Schweiz
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13
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Guida S, Farnetani F, Nisticò SP, Mariarosaria CG, Babino G, Pellacani G, Fulgione E. New trends in botulinum toxin use in dermatology. Dermatol Pract Concept 2018; 8:277-282. [PMID: 30479855 PMCID: PMC6246063 DOI: 10.5826/dpc.0804a05] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Accepted: 05/28/2018] [Indexed: 12/17/2022] Open
Abstract
Background Recent studies have highlighted new botulinum neurotoxin (BoNT) applications in the field of dermatology. Objective To review current knowledge of BoNT use in dermatology. Methods The literature of the last 5 five years has been reviewed. Results We describe interesting protocols of BoNT treatment for hyperhidrosis (HH), hypertrophic scars and keloids, Raynaud phenomenon, facial flushing, oily skin, psoriasis, Hailey-Hailey disease, and cutaneous lesions like painful lesions and periorbital syringomas. Conclusions Several skin conditions eligible for BoNT treatment have been described. After the wide application for HH treatment, scars as well as vascular and inflammatory skin disorders, oily skin and cutaneous lesions represent fields of application of BoNT.
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Affiliation(s)
- Stefania Guida
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Italy
| | - Francesca Farnetani
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Italy
| | - Steven P Nisticò
- Department of Health Sciences, University Magna Graecia, Catanzaro, Italy
| | | | - Graziella Babino
- Department of Dermatology, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Giovanni Pellacani
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Italy
| | - Elisabetta Fulgione
- Department of Dermatology, University of Campania Luigi Vanvitelli, Naples, Italy
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14
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Rosen R, Stewart T. Results of a 10-year follow-up study of botulinum toxin A therapy for primary axillary hyperhidrosis in Australia. Intern Med J 2018; 48:343-347. [PMID: 29512329 DOI: 10.1111/imj.13727] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Revised: 05/24/2017] [Accepted: 05/24/2017] [Indexed: 11/28/2022]
Abstract
Primary hyperhidrosis has a prevalence of 3-5% in the United States. It is a psychosocially disabling condition leading to low self-esteem, chronic stress and depressive symptoms. Several medical and surgical treatments exist, including botulinum toxin A, which internationally, has been shown effectively and safely to treat this condition achieving high patient satisfaction. In Australia, botulinum toxin A has been available under the Medicare benefits scheme for axillary hyperhidrosis since 2013, but efficacy and treatment satisfaction had not been evaluated. We present the results of the first Australian study on efficacy and patient satisfaction with botulinum toxin A in primary axillary hyperhidrosis with evaluation of possible prognostic factors.
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Affiliation(s)
- Robert Rosen
- Southern Suburbs Dermatology, Sydney, New South Wales, Australia.,School of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Thomas Stewart
- Southern Suburbs Dermatology, Sydney, New South Wales, Australia.,School of Medicine, University of New South Wales, Sydney, New South Wales, Australia
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15
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Rzany B, Bechara FG, Feise K, Heckmann M, Rapprich S, Wörle B. Aktualisierung der S1-Leitlinie zur Definition und Therapie der primären Hyperhidrose. J Dtsch Dermatol Ges 2018; 16:945-953. [DOI: 10.1111/ddg.13579_g] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Berthold Rzany
- RZANY & HUND; Kurfürstendamm 183; 10707 Berlin; Deutschland
| | - Falk G. Bechara
- Abteilung für Dermatochirurgie; Klinik für Dermatologie; Venerologie und Allergologie; Ruhr-Universität Bochum; Bochum Deutschland
| | - Konstantin Feise
- Praxis Dr. Feise; Belegarzt Sophienklinik; Sophienstraße 41; 70178 Stuttgart; Deutschland
| | - Marc Heckmann
- Praxisklinik für Dermatologie; Kreuzstraße 26; 82319 Starnberg; Deutschland
| | - Stefan Rapprich
- Hautmedizin Bad Soden; Kronberger Straße 2; 65812 Bad Soden; Deutschland
| | - Birgit Wörle
- Dermatologie und Laserzentrum; Hirslanden Klinik Meggen; Klinik St. Anna AG; Meggen Schweiz
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16
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Giordano CN, Matarasso SL, Ozog DM. Injectable and topical neurotoxins in dermatology: Indications, adverse events, and controversies. J Am Acad Dermatol 2017; 76:1027-1042. [PMID: 28522039 DOI: 10.1016/j.jaad.2016.11.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 11/03/2016] [Accepted: 11/06/2016] [Indexed: 12/27/2022]
Abstract
The use of neuromodulators for therapeutic and cosmetic indications has proven to be remarkably safe. While aesthetic and functional adverse events are uncommon, each anatomic region has its own set of risks of which the physician and patient must be aware before treatment. The therapeutic usages of botulinum toxins now include multiple specialties and multiple indications. New aesthetic indications have also developed, and there has been an increased utilization of combination therapies to combat the effects of global aging. In the second article in this continuing medical education series, we review the prevention and treatment of adverse events, therapeutic and novel aesthetic indications, controversies, and a brief overview of combination therapies.
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Affiliation(s)
| | - Seth L Matarasso
- Department of Dermatology, University of California, San Francisco School of Medicine, San Francisco, California
| | - David M Ozog
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan.
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17
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Sánchez-Carpintero I, Martín-Gorgojo A, Ruiz-Rodríguez R. Microwave Treatment for Axillary Hyperhidrosis and Bromhidrosis. ACTAS DERMO-SIFILIOGRAFICAS 2017. [DOI: 10.1016/j.adengl.2017.03.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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18
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Tratamiento con microondas en la hiperhidrosis y bromhidrosis axilar. ACTAS DERMO-SIFILIOGRAFICAS 2017; 108:418-422. [DOI: 10.1016/j.ad.2016.12.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 12/09/2016] [Indexed: 11/17/2022] Open
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19
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He J, Wang T, Dong J. A low initial botulinum toxin A treatment response does not predict poor long-term outcomes in patients with axillary bromhidrosis. J DERMATOL TREAT 2017; 29:102-104. [PMID: 28489483 DOI: 10.1080/09546634.2017.1329512] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Jinguang He
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People’s Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, P.R. China
| | - Tao Wang
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People’s Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, P.R. China
| | - Jiasheng Dong
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People’s Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, P.R. China
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20
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Clerico C, Fernandez J, Camuzard O, Chignon-Sicard B, Ihrai T. Hyperhidrose axillaire, traitement par injection de toxine botulique de type A : revue de la littérature. ANN CHIR PLAST ESTH 2016; 61:60-4. [DOI: 10.1016/j.anplas.2014.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Accepted: 11/29/2014] [Indexed: 10/24/2022]
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21
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Brehmer F, Lockmann A, Grönemeyer LL, Kretschmer L, Schön MP, Thoms KM. Wiederholte Injektionen von Botulinumtoxin Typ A steigern kontinuierlich die Wirkdauer bei primärer axillärer Hyperhidrose: Eine retrospektive Analyse von 101 Patienten. J Dtsch Dermatol Ges 2015. [DOI: 10.1111/ddg.50_12623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Franziska Brehmer
- Klinik für Dermatologie, Venerologie und Allergologie; Universitätsmedizin Göttingen; Göttingen Deutschland
| | - Anike Lockmann
- Klinik für Dermatologie, Venerologie und Allergologie; Universitätsmedizin Göttingen; Göttingen Deutschland
| | - Lisa-Lena Grönemeyer
- Klinik für Dermatologie, Venerologie und Allergologie; Universitätsmedizin Göttingen; Göttingen Deutschland
| | - Lutz Kretschmer
- Klinik für Dermatologie, Venerologie und Allergologie; Universitätsmedizin Göttingen; Göttingen Deutschland
| | - Michael P. Schön
- Klinik für Dermatologie, Venerologie und Allergologie; Universitätsmedizin Göttingen; Göttingen Deutschland
| | - Kai-Martin Thoms
- Klinik für Dermatologie, Venerologie und Allergologie; Universitätsmedizin Göttingen; Göttingen Deutschland
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Brehmer F, Lockmann A, Grönemeyer LL, Kretschmer L, Schön MP, Thoms KM. Repetitive injections of botulinum toxin A continuously increase the duration of efficacy in primary axillary hyperhidrosis: a retrospective analysis in 101 patients. J Dtsch Dermatol Ges 2015; 13:799-805. [PMID: 26176740 DOI: 10.1111/ddg.12623] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES Botulinum toxin type A is an effective, well-tolerated, albeit temporary treatment for primary axillary hyperhidrosis. However, little is known about the influence of repetitive injections on the duration of efficacy. PATIENTS AND METHODS 139 patients with primary axillary hyperhidrosis were injected with 50 units of botulinum toxin per axilla. In 101 patients, who received at least three treatments, the duration of efficacy after the first, second, and last treatment was evaluated. RESULTS The median duration of efficacy was 4.0 months, 4.5 months, and 5.0 months after the first, second, and last injection, respectively. Overall, the duration of efficacy was significantly longer after the last injection compared to the duration of efficacy after the first injection (p = 0.0055, Wilcoxon matched-pairs signed-rank test). Likewise, the difference between the first and second injection (p = 0.0302) as well as the difference between the second and the last injection (p = 0.0381) were significant. In 25.7 % of patients, the duration of efficacy remained unchanged over the entire treatment period. CONCLUSIONS Repetitive botulinum toxin treatments led to a significantly increased duration of efficacy in axillary hyperhidrosis. While the average duration of efficacy continued to increase with each treatment, there were considerable interindividual differences.
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Affiliation(s)
- Franziska Brehmer
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Anike Lockmann
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Lisa-Lena Grönemeyer
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Lutz Kretschmer
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Michael P Schön
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Kai-Martin Thoms
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
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Prise en charge d’une hyperhidrose. Ann Dermatol Venereol 2015; 142:252-61. [DOI: 10.1016/j.annder.2014.11.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Revised: 10/03/2014] [Accepted: 11/07/2014] [Indexed: 11/22/2022]
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Dessart P, Truchot E, Maillard H. Frey's syndrome and botulinum toxin type A: duration of efficacy and patient satisfaction. J Eur Acad Dermatol Venereol 2015; 30:907-9. [PMID: 25727247 DOI: 10.1111/jdv.13079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- P Dessart
- Department of Dermatology, Centre Hospitalier du Mans, Le Mans, France
| | - E Truchot
- Department of Otorhinolaryngology, Centre Hospitalier du Mans, Le Mans, France
| | - H Maillard
- Department of Dermatology, Centre Hospitalier du Mans, Le Mans, France
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Abstract
Primary hyperhidrosis (HH), a condition of sweating in excess of thermoregulatory requirements, affects nearly 3% of the US population and carries significant emotional and psychosocial implications. Unlike secondary HH, primary HH is not associated with an identifiable underlying pathology. Our limited understanding of the precise pathophysiologic mechanism for HH makes its treatment particularly frustrating. However, a wide array of interventions for the treatment of HH have been implemented throughout the world. Herein, we discuss the most extensively studied therapeutic options for primary HH, including systemic oxybutynin, botulinum toxin injections, skin excision, liposuction–curettage, and sympathotomy/sympathectomy. We conclude with a discussion of possible future therapies for HH, including the applications of laser, microwave, and ultrasound technologies.
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Affiliation(s)
- Anna-Bianca Stashak
- Internal Medicine Residency Program, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Jerry D Brewer
- Division of Dermatologic Surgery, Department of Dermatology, Mayo Clinic, Rochester, MN, USA
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Abstract
PURPOSE OF REVIEW Primary focal hyperhidrosis is a common condition that negatively impacts quality of life for many pediatric patients and can be challenging to treat. Standard treatments for hyperhidrosis can be used with success in many patients, and newer therapies and techniques offer options that have demonstrated efficacy and safety. This review highlights standard therapies for primary focal hyperhidrosis as well as the most recent technique advancements and alternative treatment options. RECENT FINDINGS The standard approach to treating primary focal hyperhidrosis remains initiation of topical preparations, followed by advancement to systemic medications, local administration of medication and/or surgical procedures. Recent studies focus on enhancing tolerability of topical preparations as well as evaluating the efficacy of neuromodulator injections, oral anticholinergic medications and laser therapy. Microwave technology has also been introduced for the treatment of focal hyperhidrosis with promising results. SUMMARY Many therapies exist for hyperhidrosis, and each treatment plan must be evaluated on a patient-by-patient basis. Advances in standard therapies and emergence of new treatment techniques are the main emphases of current published literature on hyperhidrosis. This article presents recent therapeutic options as well as updates on more established strategies to help practitioners treat this challenging condition.
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Lecouflet M, Leux C, Fenot M, Célerier P, Maillard H. Duration of efficacy increases with the repetition of botulinum toxin A injections in primary palmar hyperhidrosis: A study of 28 patients. J Am Acad Dermatol 2014; 70:1083-7. [DOI: 10.1016/j.jaad.2013.12.035] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Revised: 12/19/2013] [Accepted: 12/20/2013] [Indexed: 10/25/2022]
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