Evaluation of treatment of axillary and palmar hyperhidrosis with

Abstract

Introduction: Hyperhidrosis is a skin condition were patients sweat excessively. It affects 3 % of the population and has a major impact on quality of life. Primary hyperhidrosis has a mostly unknown pathogenesis, but sympathetic overstimulation of sweat glands is a main cause. Sahlgrenska’s dermatology department started offering botulinum toxin (botox) injections in September 2013 after a Health Technology Assessment concluded that there was scientific evidence to support palmar and axillary treatment. Since then 179 unique patients have received injections but this far no evaluation has been made. Aim: To evaluate the hyperhidrosis treatment with botox in the clinic by examining life quality in the patients, duration of treatment effect, effectiveness of treatment and side-effects. Methods: The treatment form data was assembled in Microsoft Excel. Melior was used to search for any missing data. Analysis was performed with the help of the department statistician, who used the R-project statistics program. Results: Pre-treatment dermatology life quality index (DLQI) showed significant improvement (p < 0.0001) over time for all age groups and for both palmar and axillary treatment. Duration only increased significantly (p < 0.05) between treatment 1 and 2 for palmar patients < 20 and 20-30 years. Effectiveness of treatment was significantly higher for axillary treatment (mean 8.6) compared to palmar (mean 8.1). Pain from treatment was best reduced with nerve block, though this caused most pain by administration. Ice did not significantly differ from being without anesthetics in terms of treatment pain reduction. Sideeffects were mostly unreported: 3 % of the appointments reported muscle weakness, 1 % fainting and 0.4 % increased general sweating. Conclusion: Treatment with botox injections improves quality of life in hyperhidrosis patients over time, and not only when treatment is in effect.