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 Botulinum Toxin
 A injections     

Treatment
 algorithm for

A.        15 % AlCl3.6H2O / in a salicylic acid gel : Hydrosal®

B.        20 % AlCl3.6H2O / in absolute alcohol : Drysol®. If irritation, 1% d’HC cream could be used 15 minutes before the application of AlCl3

C.        30 % AlCl3.6H2O / in a salicylic acid gel

D.        if intolerance, try Secure (glycopyrrolate 1% cream)

apply on hairline of forehead and occipital area.

A.        Botox injections 100 units.

B.        Botox injections 100 units + 30 % AlCl3.6H2O / in a salicylic acid gel

C.        Botox injections 200 units on forehead and scalp.

A.        Glycopyrollate (Robinul,Avert) 1 to 2 mg tid prn.

B.        Propantheline (Pro-Banthine) 7.5 mg tid.

C.        Oxybutynin Hydrochloride (Ditropan) 5mg tid prn

D.        Endoscopic Transthoracic Sympathectomy

Beware of the side-effects : dry mouth, constipation, palpitation, blurred vision, urinary retention and other.