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Onabotulinum
toxin A injections
     

  Definition   Medications  

Treatment
 algorithm for

 
  Prevalence   Systemic treatment    
  Impact on quality of life   Topical treatment     Axillary and inguinal HH  

    for armpits

 >     VIDEO
  Classification   The gel Advantage     Palmoplantar HH  

    for hands

 >     VIDEO
  The Control of sweating   Needle Free Injections     Craniofacial HH  

    for feet

 >     VIDEO

Therapeutic algorithm for palmar and plantar HH in adults

Palmar and plantar hyperhidrosis: a practical management algorithm. Therapy 2007;4(3):279-283.
 

Very Mild

A.       15 % AlCl3.6H2O / in SA gel : Hydrosal®

B.       20 % AlCl3.6H2O / in absolute ethanol : Drysol® if AlCl3 irritates the skin: 1% HC cream
  could be used 15 minutes before or an hour after the application of AlCl3

..Mild

A.       30 % AlCl3.6H2O / in SA gel*

B.       40 % AlCl3.6H2O / in  SA gel*
 

..Moderate

A.    55 % AlCl3.6H2O / in  6 % SA gel*

B.   Iontophoresis (with or without 40-55 % AlCl3.6H2O / in a 6 % SA gel*)
Idrostar , Drionic , Fischer

Home made devices have also been used successfully but their safety is uncertain.

C.   Botox injections 100 units per palm or 150 units per sole

D.   Botox injections 100 units per palm or 150 units per sole + 55 % AlCl3.6H2O / in  6 %  SA gel*

..Severe

A.     Botox injections 150 units per palm or 200 units per sole

B.     Botox injections 150 units per palm or 200 units per sole + 55 % AlCl3.6H2O / in  6 %
  SA gel
*

C.     Endoscopic Transthoracic Sympathectomy (ETS) for palmar HH and lumbar sympathectomy
        for plantar HH

* The concentration of SA in the gel is 3 to 4% unless specified otherwise

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Revision date
05/20/2015



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