Effective treatment of frontal hyperhidrosis with botulinum toxin A

Abstract
Background Focal hyperhidrosis is a common condition mostly confined to the axillae, palms and soles. In some individuals, predominantly men, increased sweating of the forehead may be the major complaint and may interfere with the person’s quality of life. Botulinum toxin A has been shown to be a very effective treatment for focal hyperhidrosis of the axillae and palms. Objectives To assess the response in 10 men suffering from frontal hyperhidrosis treated with botulinum toxin A. Methods Botulinum toxin A Botox® was injected at multiple sites evenly distributed over the forehead (mean dose 86 mouse units) . Results The mean ± SEM amount of sweat was significantly reduced, 4 weeks after treatment, from 173·8 ± 38·6 mg min−1 to 53·7 ± 17·6 mg min−1. The effect lasted at least 5 months in nine of the 10 patients. All patients subjectively judged the treatment as very effective. Minor side‐effects included painful injections and a transient weakness of forehead muscles without ptosis. Conclusions In this study, we provide evidence that botulinum toxin A is an effective and safe treatment for frontal hyperhidrosis.