We read with interest the article by Naumann et al1 on botulinum toxin therapy for focal hyperhidrosis and would like to contribute our own findings regarding the long-term efficacy of botulinum toxin therapy, as well as the putative effects on apoeccrine secretion. After our initial reports on the efficacy of high-dose (500 U per axilla) botulinum toxin A (Dysport, Ipsen Biotech, Paris, France) in a series of selected patients with severe axillary2 and compensatory3 hyperhidrosis (sweat secretion up to 800 mg/min), we recently conducted a 1-year follow-up (M.H., S. Breit, MD, A. C-B., and G.P., unpublished data, May 1998). Nine of 12 patients were still satisfied with sweat control that was consistently below 100 mg/min measured using gravimetry on several occasions. Three patients showed mitigated recurrence of axillary hyperhidrosis after 3, 4, and 7 months, respectively, which could be overcome by a second injection of botulinum toxin A with lasting efficacy. It should be noted that at present 2 preparations of botulinum toxin A are commercially available (Botox, Allergan, Irvine, Calif, and Dysport, Ipsen Biotech), which have to be distinguished regarding their respective dosage.
Heckmann M, Schaller M, Ceballos-Baumann A, Plewig G. Follow-up of Patients With Axillary Hyperhidrosis After Botulinum Toxin Injection. Arch Dermatol. 1998;134(10):1298-1299. doi: