Botulinum toxin injections and suction-curettage have been separately shown to be effective in treating axillary hyperhidrosis but have not been compared in the same patients.
We sought to compare effectiveness of suction-curettage versus neurotoxin for the treatment of axillary hyperhidrosis.
Each of 20 patients was randomized to receive toxin injections to one axilla and suction-curettage to the contralateral axilla. The primary outcome measure was reduction of sweat rate measured by gravimetry, and the secondary measure was quality of life as measured by a patient-directed questionnaire.
At 3 months posttreatment, toxin injections decreased baseline resting sweat production by 72.1% versus 60.4% (P = .29) for suction-curettage, and baseline exercise-induced sweat production by 73.8% versus 58.8% (P = .10). When patients were stratified into the categories of light and heavy sweaters, there was a difference among heavy sweaters, with exercise-induced sweat production lower by 10.48 mg/min or 34.3% (P = .0025) at toxin-treated sites. Compared with suction-curettage, toxin also resulted in greater improvements in quality of life by 0.80 points (P = .0002) and 0.90 points (P = .0017) at 3 and 6 months posttreatment, respectively, as measured by the patient questionnaire.
The follow-up period was limited to 6 months.
By objective measures 3 months after treatment, neurotoxin injections are nominally more effective than suction-curettage in all cases, and markedly more effective in heavy sweaters. Patients have a very significant preference for neurotoxin injections at 3 months, and this is maintained at 6 months.Le texte complet de cet article est disponible en PDF.
Key words : axillary hyperhidrosis, botulinum, gravimetry, onabotulinum, suction, suction-curettage, underarm sweating
| Funded by the Department of Dermatology, Northwestern University. No funding or product was received from Allergan (manufacturer of Botox).
| Disclosure: Drs Alam and West have been investigators for other studies with Allergan (Botox), but no compensation was received by them from these earlier, unrelated studies. Drs Ibrahim, Kakar, Bolotin, Disphanurat, Becker, Poon, and Veledar; Mr Nodzenski; and Ms Pace have no conflicts of interest to declare.