Primary Focal Hyperhidrosis is a disorder that results in considerable functional and psychosocial impairment. Patients experience symptoms for years before presenting to their dermatologists.

Multiple treatment modalities exist. Their efficacy depends on the body area affected and  severity of the sweating, and  patient’s tolerance and response to previous treatments. Healthcare professionals should be aware of the risks, benefits, cost, and reasonable expectations associated with the available treatment modalities. Conservative measures

are attempted before invasive and irreversible options, even in patients with severe hyperhidrosis.

BTX-A provides excellent efficacy in achieving anhidrosis and improves patients’ quality of life for a relatively long duration. Along with DIGITAL IONTOPHORESISIS, BOTOX

may be considered a first-line therapy for moderate-to-severe PALMO-PLANTER  HYPERHIDROSIS

Treatment options should be tailoredto each patient individually, taking risks, benefits, cost, and convenience into account.

Palmar Hyperhidrosis

Efficacy of BTX-A on palmar Hyperhidrosis both quantitatively and subjectively  is around 80–90%.. The duration of anhidrosis is approximately 6 months, and ranges from 4 to 12 months.

Adverse Events

Transient weakness of the intrinsic hand muscles is the most noteworthy adverse event when using BTX for palmar HH.The weakness usually begins after 1–3 days and resolves within 10–14 days.   handgrip strength is generally normal in most patients, yet finger pinch strength is often reduced i.e poor fine motor control.

Pain and soreness during thprocedure and for up to 1–2 days due to the multiple injections into the palm.Proper anesthesia ensures patient compliance.  Mild numbness and paresthesias, are transient in treated patients.

Dosing

The dose required to effectively treat palmar symptoms ranges from 100 to 240 U of Botox. Doses should be tailored , with injections of approximately 2–3 U of Botox_ spaced every 1–2 cm.