Abstract
Primary focal hyperhidrosis is a common autonomic disorder that significantly impacts
quality of life. It is characterized by excessive sweating confined to circumscribed
areas, such as the axillae, palms, soles, and face. Less frequent types of focal hyperhidrosis
secondary to underlying causes include gustatory sweating in Frey's syndrome and compensatory
sweating in Ross' syndrome and after sympathectomy. Approval of onabotulinumtoxinA
for severe primary axillary hyperhidrosis in 2004 has revolutionized the treatment
of this indication. Meanwhile further type A botulinum neurotoxins like abobotulinumtoxinA
and incobotulinumtoxinA, as well as the type B botulinum neurotoxin rimabotulinumtoxinB
are successfully used off-label for axillary and various other types of focal hyperhidrosis.
For unexplained reasons, the duration of effect differs considerably at different
sites. Beside hyperhidrosis, botulinum neurotoxin is also highly valued for the treatment
of sialorrhea affecting patients with Parkinson's disease, cerebral palsy, amyotrophic
lateral sclerosis, motor neuron disease, and other neurologic conditions. With correct
dosing and application, side effects are manageable and transient.
Keywords
botulinum neurotoxin - focal hyperhidrosis - sweating - sialorrhea - autonomic disorders
