Improving Botulinum Toxin Therapy for Palmar Hyperhidrosis: Wrist Block and Technical Considerations

Botulinum A exotoxin has become an excellent therapeutic option to treat focal hyperhidrosis, but when the problem affects the palmar region the technique has some drawbacks. Pain with injection is difficult to tolerate and the large dose needed to treat both hands are two concerns, as well as muscl...

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Bibliographic Details
Published in:Dermatologic surgery 2001-01, Vol.27 (1), p.34-36
Main Authors: TRINDADE DE ALMEIDA, ADA REGINA, KADUNC, BOGDANA VICTORIA, MARTINS DE OLIVEIRA, EDUARDO MISSIAS
Format: Article
Language:English
Subjects:
Biological and medical sciences
Botulinum Toxins, Type A - administration & dosage
Botulinum Toxins, Type A - adverse effects
Hand - innervation
Humans
Hyperhidrosis - therapy
Injections - adverse effects
Injections - instrumentation
Injections - methods
Median Nerve
Medical sciences
Nerve Block - methods
Pain - etiology
Pain - prevention & control
Pharmacology. Drug treatments
Radial Nerve
Skin, nail, hair, dermoskeleton
Ulnar Nerve
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Description
Summary:Botulinum A exotoxin has become an excellent therapeutic option to treat focal hyperhidrosis, but when the problem affects the palmar region the technique has some drawbacks. Pain with injection is difficult to tolerate and the large dose needed to treat both hands are two concerns, as well as muscle weakness secondary to botulinum toxin diffusion and the possibility of antibody production. All these problems limit the number of patients treated. The authorʼs suggestion is to treat only the dominant hand, after performing a wrist block. The use of a device adapted from a cartridge rubber may help to control the injection depth and the risk of muscular weakness.
ISSN:1076-0512
1524-4725
DOI:10.1097/00042728-200101000-00010