Hyperhidrosis, which is sweating in excess of that required for normal thermoregulation, is a condition that usually begins in either childhood or adolescence. Although any site on the body can be affected, the sites most commonly affected are the palms, soles, and axillae. This condition may be idiopathic or secondary to other diseases, metabolic disorders, febrile illnesses, or medication use. Hyperhidrosis exists in 3 forms: emotionally induced (in which it affects the palms, soles, and axillae1,2), localized, or generalized. The condition often causes great emotional distress and occupational disability for the patient, regardless of the form.
There are many terapeutical procedures that include topical application of aluminum chloride in various concentrations, iontophoresis, surgical procedures (sympathectomy or glandular curettage).
The most effective and safe treatment is the injections of botulinum toxine tip A (Botox, Vistabel , Dysport)
The botulinum toxin inhibits the release of acetylcholine at the neuromuscular junction and affects the postganglionic sympathetic innervation of the sweat glands.
It is necessary multiple injections placed at 1-2 cm distance between them in the whole affected area. Usually, the response become visible after one week and it last for six month.
The injections may be painfull and that is why it is necessary the anesthesia (local, regional or intravenous).
The possible side effects reported include a slight palmar or axillar muscle weakness or little hematomas at the site of the injections.