Primary hyperhidrosis (HH) commonly affects the axillae, palms, soles, face, and/or the groin. There are limited treatment options available for HH of areas other than the axillae and palms/soles. Botulinum neurotoxin-A is an effective and safe treatment option for most hyperhidrotic areas of the body. Areas that are commonly affected, such as the face and groin, and less common areas like the submammary region and gluteal cleft are discussed. Frey syndrome, compensatory sweating, and postamputation stump HH are also discussed.
Key points
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Hyperhidrosis can affect many different areas of the body. Identifying and localizing the specific hyperhidrotic area with starch-iodine testing is important.
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Botulinum neurotoxin-A is an effective and safe treatment option for hyperhidrotic areas of the body.
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Patients should be counseled about their expectations with treatment.
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Injections should be placed at the dermal-subcutaneous junction.
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The dosing and the duration of effect of botulinum toxin are variable, and depend on the location and size of the involved area.
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