Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-669899f699-cf6xr Total loading time: 0 Render date: 2025-04-27T07:08:28.455Z Has data issue: false hasContentIssue false

9 - Hyperhidrosis

Published online by Cambridge University Press:  02 December 2009

By
DeeAnna Glaser  and
Stephanie Benson
Edited by
Anthony B. Ward  and
Michael P. Barnes
DeeAnna Glaser
Affiliation:
Department of Dermatology, Saint Louis University School of Medicine, St Louis, MO, USA
Stephanie Benson
Affiliation:
University of Colorado, School of Medicine, Denver
Anthony B. Ward
Affiliation:
University Hospital of North Staffordshire
Michael P. Barnes
Affiliation:
Hunters Moor Regional Neurological Rehabilitation Centre
Get access

Summary

Introduction

Sweating is a normal physiological response to increasing body temperature and is an important mechanism in releasing heat produced from endogenous and exogenous sources. The heat regulatory center is located in the brain within the hypothalamus, particularly involving the pre-optic and anterior nuclei. These sections of the brain monitor core body temperature through the blood stream, and the body's response to increasing temperature is to release heat through sweat.

Sweating is controlled by the sympathetic nervous system through its preganglionic and postganglionic pathways. Nerve fibers exit the pre-optic or anterior nuclei and descend ipsilaterally through the spinal cord until they reach the intermediolateral column, where they leave the cord and enter the sympathetic chain. The postganglionic fibers leave the chain and join the peripheral nerves until they reach the sweat gland. The neurotransmitter for the sympathetic nervous system is generally norepinephrine; however, the neurotransmitter mainly involved in the sweating process is acetylcholine. Other chemical mediators found in the neuromuscular junction during sweating include vasoactive intestinal peptide, atrial natriuretic peptide, galanin, and calcitonin gene related peptide.

Three glands are important in the creation of sweat: the eccrine, apo-eccrine, and apocrine glands. They are located superiorly in the subcutaneous fat at the junction of the dermis and subcutaneous fat. Between two and four million eccrine glands are found within the skin, and their function is to secrete water while conserving sodium chloride for electrolyte maintenance. The eccrine gland consists of a secretory coil and a duct.

Type
Chapter
Information
Clinical Uses of Botulinum Toxins , pp. 175 - 200
Publisher: Cambridge University Press
Print publication year: 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Book purchase

Temporarily unavailable

References

Goldsmith, L. (1999). Biology of eccrine and apocrine sweat glands. In Freedberg, I., Eisen, A., Wolff, K., Goldsmith, L., Katz, S. I. and Fitzpatrick, T., eds., Fitzpatrick's Dermatology in General Medicine. New York: McGraw-Hill, pp. 157–64.Google Scholar
Goldsmith, L. (1999). Goldsmith disorders of the eccrine sweat gland. In Freedberg, I., Eisen, A., Wolff, K., Goldsmith, L., Katz, S. I. and Fitzpatrick, T., eds., Fitzpatrick's Dermatology in General Medicine. New York: McGraw-Hill, pp. 800–9.Google Scholar
Stenn, K. and Bhawan, J. (2000). The normal histology of the skin. In Farmer, E. and Hood, A., eds., Pathology of the Skin. New York: McGraw-Hill.Google Scholar
Glogau, R. (1998). Botulinum A neurotoxin for axillary hyperhidrosis: no sweat BOTOX. Dermatologic Surgery, 24, 817–19.CrossRefGoogle ScholarPubMed
Kreyden, O. and Scheidegger, P. (2004). Anatomy of the sweat glands, pharmacology of botulinum toxin, and distinctive syndromes associated with hyperhidrosis. Clinics in Dermatology, 22, 40–4.CrossRefGoogle ScholarPubMed
Hund, M., Kinkelin, I., Naumann, M. and Hamm, H. (2002). Definition of axillary hyperhidrosis by gravimetric assessment. Archives of Dermatology, 138, 539–41.CrossRefGoogle ScholarPubMed
Odderson, I. (1998). Hyperhidrosis treated by botulinum A exotoxin. Dermatological Surgery, 24, 1237–41.CrossRefGoogle ScholarPubMed
Cheshire, W. and Freeman, R. (2003). Disorders of sweating. Seminars in Neurology, 23(4), 399–407.Google ScholarPubMed
Hornberger, J., Grimes, K., Naumann, M., Glaser, D., Lowe, N. J., Naver, H.et al. (2004). Recognition, diagnosis, and treatment of primary focal hyperhidrosis. Journal of American Academy of Dermatology, 51, 274–86.CrossRefGoogle Scholar
Dangoisse, C. and Song, M. (2000). Hyperhidrosis. In Arper, J., Oranje, A. and Prose, N., eds., Textbook of Pediatric Dermatology. London: Blackwell Science Ltd.Google Scholar
Kreyden, O., Schmid-Grendelmeier, P. and Burg, G. (2001). Idiopathic localized unilateral hyperhidrosis: case report of successful treatment with botulinum toxin type A and review of the literature. Archives of Dermatology, 137(12), 1622–5.CrossRefGoogle ScholarPubMed
Seline, P. and Jaskierny, D. (1999). Cutaneous metastases from a chondroblastoma initially presenting as unilateral palmar hyperhidrosis. Journal of American Academy of Dermatology, 40, 325–7.CrossRefGoogle ScholarPubMed
Strutton, D., Kowalski, J., Glaser, D. and Stang, P. (2004). US prevalence of hyperhidrosis and impact on individuals with axillary hyperhidrosis: results from a national survey. Journal of American Academy of Dermatology, 51, 241–8.CrossRefGoogle ScholarPubMed
Naumann, M. (2001). Evidence-based medicine: botulinum toxin in focal hyperhidrosis. Journal of Neurology, 248(Suppl. 1), S31–S33.CrossRefGoogle Scholar
Glagau, R. (2004). Hyperhidrosis and botulinum toxin A: patient selection and techniques. Clinics in Dermatology, 22, 45–52.CrossRefGoogle Scholar
Kowalski, J., Ravelo, A., Glaser, D. and Lowe, N. J. (2003). Quality-of-Life Effect of Botulinum Toxin Type A on Patients with Primary Axillary Hyperhidrosis: Results from a North American Clinical Study Population, p. 196. American Academy of Dermatology Annual Meeting.
Kowalski, J., Glaser, D., Lowe, N. and Ravelo, A. (2003). Quality-of-Life and Economic Impact of Primary Axillary Hyperhidrosis: Results from a North American Clinical Study Population, p. 198. American Academy of Dermatology Annual Meeting.
Hornberger, J., Grimes, K., Naumann, M., Glaser, D. A., Lowe, N. J., Naver, H., Ahn, S. and Stolman, L. P. (2004). Multi-Specialty Working Group on the recognition, diagnosis, and treatment of primary focal hyperhidrosis. Recognition, diagnosis, and treatment of primary focal hyperhidrosis. Journal of the American Academy of Dermatology, 51(2), 274–86.CrossRefGoogle Scholar
Adar, R. (1977). Palmar hyperhidrosis and its surgical treatment: a report of 100 cases. Annals of Surgery, 186(1), 34–41.CrossRefGoogle ScholarPubMed
Naumann, M., Hamm, H. and Lowe, N. J. (2002). Effect of botulinum toxin type A on quality of life measures in patients with excessive axillary sweating: a randomized controlled trial. British Journal of Dermatology, 147, 1218–26.CrossRefGoogle ScholarPubMed
Tan, S. and Solish, N. (2002). Long-term efficacy and quality of life in the treatment of focal hyperhidrosis with botulinum toxin A. Dermatological Surgery, 28, 495–9.Google ScholarPubMed
Swartling, C., Naver, H. and Lindberg, M. (2001). Botulinum A toxin improves life quality in severe primary focal hyperhidrosis. European Journal of Neurology, 8(3), 247–52.CrossRefGoogle ScholarPubMed
Bushara, K. and Park, D. (1994). Botulinum toxin and sweating. Journal of Neurology, Neurosurgery and Psychiatry, 57(11), 1437–8.CrossRefGoogle ScholarPubMed
Tugnoli, A., Ragona, R., Eleopra, R., Grandis, D. and Montecucco, C. (2001). Treatment of Frey syndrome with botulinum toxin type A. Archives of Otolaryngology – Head and Neck Surgery, 127, 339–40.Google Scholar
Schnider, P., Binder, M., Auff, E., Kittler, H., Berger, T. and Wolff, K. (1997). Double-blind trial of botulinum A toxin for the treatment of focal hyperhidrosis of the palms. British Journal of Dermatology, 136, 548–52.CrossRefGoogle ScholarPubMed
Heckmann, M., Ceballos-Baumann, A. and Plewig, G. (2001). Botulinum toxin A for axillary hyperhidrosis (excessive sweating). New England Journal of Medicine, 344(7), 488–93.CrossRefGoogle Scholar
Lowe, N., Yamauchi, P., Lask, G., Patnaik, R. and Iyer, S. (2002). Efficacy and safety of botulinum toxin type A in the treatment of palmar hyperhidrosis: a double-blind, randomized, placebo-controlled study. Dermatological Surgery, 28, 822–7.Google Scholar
Glaser, D., Kowalski, J., Eadie, N., Solish, N., Ravelo, A., Weng, Y.et al. (2004). Hyperhidrosis disease severity scale (HDSS): validity and reliability results from three studies. Journal of the American Academy of Dermatology, 51(2), 241–8.Google Scholar
Heckmann, M., Breit, S., Ceballos-Baumann, A., Schaller, M. and Plewig, G. (1999). Side-controlled intradermal injection of botulinum toxin A in recalcitrant axillary hyperhidrosis. Journal of the American Academy of Dermatology, 41, 987–90.CrossRefGoogle ScholarPubMed
Klaber, M. and Catterall, M. (2002). Treating hyperhidrosis: anticholinergic drugs were not mentioned. British Journal of Dermatology, 321(7262), 703.Google Scholar
Stolman, L. (1987). Treatment of excess sweating of the palms by iontophoresis. Archives of Dermatology, 123, 893–6.CrossRefGoogle ScholarPubMed
Stolman, L. (1998). Treatment of hyperhidrosis. Dermatologic Clinics, 16, 863–7.CrossRefGoogle ScholarPubMed
Swinehart, J. (2000). Treatment of axillary hyperhidrosis: combination of the starch–iodine test with the tumescent liposuction technique. Dermatological Surgery, 26, 392–6.CrossRefGoogle ScholarPubMed
Luh, J. and Blackwell, T. (2002). Craniofacial hyperhidrosis successfully treated with topical glycopyrrolate. Southern Medical Journal, 95(7), 756–8.CrossRefGoogle ScholarPubMed
Gossot, D., Galetta, D., Pascal, A. and Debrosse, D. (2003). Long-term results of endoscopic thoracic sympathectomy for upper limb hyperhidrosis. Annals of Thoracic Surgery, 75, 1075–9.CrossRefGoogle ScholarPubMed
Belin, E. and Polo, J. (2003). Treatment of compensatory hyperhidrosis with botulinum toxin type A. Cutis, 71, 68–70.Google ScholarPubMed
Kim, B., Oh, B. and Park, Y. (2001). Microinvasive video-assisted thoracoscopic sympathectomy for primary palmar hyperhidrosis. American Journal of Surgery, 181(6), 540–2.CrossRefGoogle ScholarPubMed
Andrews, B. and Rennie, J. (1997). Predicting changes in the distribution of sweating following thoracoscopic sympathectomy. British Journal of Surgery, 84(12), 1702–4.CrossRefGoogle ScholarPubMed
Kao, M., Chen, Y., Lin, J., Hsieh, C. and Tsai, J. (1996). Endoscopic sympathetic treatment for craniofacial hyperhidrosis. Archives of Surgery, 131(10), 1091–4.CrossRefGoogle Scholar
Naumann, M. and Lowe, N. J. (2001). Botulinum toxin type A in treatment of bilateral primary axillary hyperhidrosis: randomised, parallel group, double blind placebo-controlled trial. British Medical Journal, 323, 596–9.CrossRefGoogle ScholarPubMed
Glaser, D., Lowe, N. J., Eadie, N., Daggett, S., Mordaunt, J. and Kowalski, J. (2004). 52-Week prospective randomized double-blind placebo-controlled safety and efficacy study of two dosages of botulinum toxin type A treatment for primary axillary hyperhidrosis. 56th Annual Meeting American Academy Neurology, P158, 4–29.Google Scholar
Odderson, I. (2002). Long-term quantitative benefits of botulinum toxin type A in the treatment of axillary hyperhidrosis. Dermatological Surgery, 28, 480–3.Google ScholarPubMed
Wollina, U., Karamfilov, T. and Konrad, H. (2002). High-dose botulinum toxin type A therapy for axillary hyperhidrosis markedly prolongs the relapse-free interval. Journal of American Academy of Dermatology, 46, 536–40.CrossRefGoogle ScholarPubMed
Naumann, M., Lowe, N., Kumar, C. and Hamm, H. (2003). Botulinum toxin type A is a safe and effective treatment for axillary hyperhidrosis over 16 months: a prospective study. Archives of Dermatology, 139(6), 731–6.CrossRefGoogle Scholar
Galadari, I. and Alkaabi, J. (2003). Botulinum toxin in the treatment of axillary hyperhidrosis. Skinmed, 2(4), 209–11.Google ScholarPubMed
Glaser, D. (2004). Treatment of axillary hyperhidrosis by chemodenervation of sweat glands using botulinum toxin type A. Journal of Drugs in Dermatology, 3(6), 627–31.Google ScholarPubMed
Lowe, N. J., Campanati, A., Bodokh, I., Cliff, S., Jaen, P., Kreyden, O.et al. (2004). The place of botulinum toxin type A in the treatment of focal hyperhidrosis. British Journal of Dermatology, 151, 1115–22.CrossRefGoogle ScholarPubMed
Schnider, P., Binder, M., Kittler, P., Birner, D., Starkel, K., Wolff, K.et al. (1999). A randomized, double-blind, placebo-controlled trial of botulinum A toxin for severe axillary hyperhidrosis. British Journal of Dermatology, 140, 677–80.CrossRefGoogle ScholarPubMed
Saadia, D., Voustianiouk, A., Wang, A. and Kaufmann, H. (2001). Botulinum toxin type A in primary palmar hyperhidrosis: randomized, single-blind, two-dose study. Neurology, 57, 2095–9.CrossRefGoogle ScholarPubMed
Wollina, U. and Karamfilov, T. (2001). Botulinum toxin A for palmar hyperhidrosis. J. European Academy of Dermatology and Venereology, 15, 555–8.CrossRefGoogle ScholarPubMed
Hund, M., Rickert, S., Kinkelin, I., Naumann, M. and Hamm, H. (2004). Does wrist nerve block influence the result of botulinum toxin A treatment in palmar hyperhidrosis?Journal of American Academy of Dermatology, 50, 61–2.CrossRefGoogle ScholarPubMed
Glogau, R. (2004). Treatment of hyperhidrosis with botulinum toxin. Dermatologic Clinics, 22, 177–85.CrossRefGoogle ScholarPubMed
Vollert, B., Blaheta, H., Moehrle, E., Juenger, M. and Rassner, G. (2001). Intravenous regional anaesthesia for treatment of palmar hyperhidrosis with botulinum toxin type A. British Journal of Dermatology, 144, 632–3.CrossRefGoogle ScholarPubMed
Trindade de Almeida, A., Kadunc, B. and Martins de Oliveira, E. (2001). Improving botulinum toxin therapy for palmar hyperhidrosis: wrist block and technical considerations. Dermatological Surgery, 27, 34–6.CrossRefGoogle Scholar
Baumann, L., Frankel, S., Esperanza, W. and Halem, M. (2003). Communications and brief reports: cryoanalgesia with dichlorotetrafluoroethane lessens the pain of botulinum toxin injections for the treatment of palmar hyperhidrosis. Archives of Dermatology, 29(10), 1057–62.Google Scholar
André, P. (2003). An easy and effective local anaesthesia for treating palmar hyperhidrosis. Journal of European Academy of Dermatology and Venereology, 17, 227–9.CrossRefGoogle ScholarPubMed
Naumann, M., Bergmann, I., Hofmann, U., Hamm, H. and Reiners, K. (1998). Botulinum toxin for focal hyperhidrosis: technical considerations and improvements in application. British Journal of Dermatology, 139, 1123–4.CrossRefGoogle ScholarPubMed
Hayton, M., Stanley, J. and Lowe, N. J. (2003). A review of peripheral nerve blockade as local anaesthesia in the treatment of palmar hyperhidrosis. British Journal of Dermatology, 149, 447–51.CrossRefGoogle ScholarPubMed
Blaheta, H., Vollert, B., Zuder, D. and Rassner, G. (2002). Intravenous regional anesthesia (Bier's block) for botulinum toxin therapy of palmar hyperhidrosis is safe and effective. Dermatologic Surgery, 28, 666–72.CrossRefGoogle ScholarPubMed
Reed, M. (2001). Surgical pearl: mechanoanesthesia to reduce the pain of local injections. Journal of the American Academy of Dermatology, 44, 671–2.CrossRefGoogle ScholarPubMed
Scherer, C., Clelland, J., O'Sullivan, P., Doleys, D. and Canan, B. (1986). The effect of two sites of high frequency vibration on cutaneous pain threshold. Pain, 25(1), 133–8.CrossRefGoogle Scholar
Glaser, D., Kokoska, M. and Kardesch, C. (2001). Botulinum Toxin Type A in the Treatment of Palmar Hyperhidrosis: the Effect of Dilution and Number of Injection Sites. American Academy of Dermatology Annual Meeting, Poster Presentation.
Vadoud-Seyedi, J., Heenen, M. and Simonart, T. (2001). Treatment of idiopathic palmar hyperhidrosis with botulinum toxin. Dermatology, 203, 318–21.CrossRefGoogle ScholarPubMed
Zaiac, M., Weiss, E. and Elgart, G. (2000). Botulinum toxin therapy for palmar hyperhidrosis with ADG needle. Dermatological Surgery, 26, 230.CrossRefGoogle ScholarPubMed
Doris, H. (2002). Cosmetic Use of Botulinum Toxin. São Paulo: AGE Editora, p. 120.Google Scholar
Naumann, M., Hofmann, U., Bergmann, I., Hamm, H., Toyka, K. and Reiners, K. (1998). Focal hyperhidrosis: effective treatment with intracutaneous botulinum toxin. Archives of Dermatology, 134(3), 301–4.CrossRefGoogle ScholarPubMed
Blaheta, H., Deusch, H., Rassner, G. and Vollert, B. (2003). Intravenous regional anesthesia (Bier's block) is superior to a peripheral nerve block for painless treatment of plantar hyperhidrosis. Journal of American Academy of Dermatology, 48(2), 301–3.CrossRefGoogle ScholarPubMed
Vadoud-Seyedi, J. (2004). Treatment of plantar hyperhidrosis with botulinum toxin type A. International Journal of Dermatology, 43, 969–71.CrossRefGoogle ScholarPubMed
Kyrmizakis, D., Pangalos, A., Papadakis, C., Logothetis, J., Maroudias, N. and Helidonis, E. (2004). The use of botulinum toxin type A in the treatment of Frey and crocodile tears syndromes. Journal of Oral and Maxillofacial Surgery, 62(7), 840–4.CrossRefGoogle ScholarPubMed
Restivo, D., Lanza, S., Patti, F., Giuffrida, S., Marchese-Ragona, R. and Bramanti, P. (2002). Improvement of diabetic autonomic gustatory sweating by botulinum toxin type A. Neurology, 59(12), 1971–3.CrossRefGoogle ScholarPubMed
Kinkelin, I., Hund, M., Naumann, M. and Hamm, H. (2000). Effective treatment of frontal hyperhidrosis with botulinum toxin A. British Journal of Dermatology, 143, 824–7.CrossRefGoogle ScholarPubMed
Böger, A., Herath, H., Rompel, R. and Ferbert, A. (2000). Botulinum toxin for treatment of craniofacial hyperhidrosis. Journal of Neurology, 414, 857–61.Google Scholar
Guntinas-Lichius, O. (2002). Increased botulinum toxin type A dosage is more effective in patients with Frey's syndrome. Laryngoscope, 112, 746–9.CrossRefGoogle ScholarPubMed
Laccourreye, O., Muscatelo, L., Bonan, B., Naude, C. and Bransu, D. (1998). Botulinum toxin type A for Frey's syndrome: a preliminary prospective study. Annals of Otorhinolaryngology, 107(1), 52–5.Google ScholarPubMed
Laskawi, R., Drobik, C. and Schonebeck, C. (1998). Up-to-date report of botulinum toxin type A treatment in patients with gustatory sweating (Frey's Syndrome). Laryngoscope, 108, 381–4.CrossRefGoogle Scholar
Guntinas-Lichius, O. (2003). Injection of botulinum toxin type B for the treatment of otolaryngology patients with secondary treatment failure of botulinum toxin type A. Laryngoscope, 113, 743–5.CrossRefGoogle ScholarPubMed
Hexsel, D. M., Dal'forno, T. and Hexsel, C. L. (2004). Inquinal or Hexsel's hyperhidrosis. Clinical Dermatology, 22(1), 53–9.CrossRef
Huh, C., Han, K., Deo, K. and Eun, H. (2002). Botulinum toxin treatment for compensatory hyperhidrosis subsequent to an upper thoracic sympathectomy. Journal of Dermatologic Treatment, 13, 91–3.CrossRefGoogle Scholar
Matarasso, S. (2005). Treatment of facial chromhidrosis with botulinum toxin type A. Journal of American Academy of Dermatology, 52(1), 89–91.CrossRefGoogle ScholarPubMed
Sanli, H., Ekmekci, P. and Akbostanci, M. (2004). Idiopathic localized crossed (left side of the upper part of the body, right side of the lower part of the body) hyperhidrosis: successful treatment of facial area with botulinum A toxin injection. Dermatologic Surgery, 30, 552–4.Google ScholarPubMed
Schlereth, T., Mouka, I., Eisenbarth, G., Winterholler, M. and Birklein, F. (2005). Botulinum toxin A (BOTOX) and sweating-dose efficacy and comparison to other BoNT preparations. Autonomic Neuroscience: Basic and Clinical, 117, 120–6.CrossRefGoogle ScholarPubMed
Birklein, F., Eisenbarth, G.Erbguth, F. and Winterholler, M. (2003). Botulinum toxin type B blocks sudomotor function effectively: a six month follow up. Journal of Investigative Dermatology, 121(6), 1312–16.CrossRefGoogle Scholar
Dressler, D., Adib Saberi, F. and Benecke, R. (2002). Botulinum toxin type B for treatment of axillar hyperhidrosis. Journal of Neurology, 249(12), 1729–32.CrossRefGoogle ScholarPubMed
Nelson, L., Bachoo, P. and Holmes, J. (2005). Botulinum toxin type B: a new therapy for axillary hyperhidrosis. British Journal of Plastic Surgery, 58, 228–32.CrossRefGoogle ScholarPubMed
Baumann, L. and Halem, M. (2003). Systemic adverse effects after botulinum toxin type B (Myobloc®) injections for the treatment of palmar hyperhidrosis. Archives of Dermatology, 139, 226–7.CrossRefGoogle Scholar
Baumann, L., Slezinger, A., Halem, M., Vujevich, J., Mallin, K. and Charles, C. (2005). Double-blind, randomized placebo controlled pilot study of the safety and efficacy of Myobloc (botulinum toxin type B) for the treatment of palmar hyperhidrosis. Dermatologic Surgery, 31, 263–70.CrossRefGoogle ScholarPubMed
Hecht, M., Birklein, F. and Winterholler, M. (2004). Successful treatment of axillary hyperhidrosis with very low doses of botulinum toxin B: a pilot study. Archives of Dermatology Research, 295, 318–19.CrossRefGoogle ScholarPubMed
Krogstad, A., Skymne, A., Pegenius, G., Elam, M. and Wallin, B. (2005). No compensatory sweating after botulinum toxin treatment of palmar hyperhidrosis. British Journal of Dermatology, 152, 329–33.CrossRefGoogle ScholarPubMed
Kavanagh, G., Oh, C. and Shams, K. (2004). BOTOX® delivery by iontophoresis. British Journal of Dermatology, 151, 1093–5.CrossRefGoogle Scholar
Naver, H., Swartling, C. and Aquilonius, S. (1999). Treatment of focal hyperhidrosis with botulinum toxin type A; a brief overview of methodology and two years' experience. European Journal of Neurology, 6(4), S117–S120.CrossRefGoogle Scholar
Solomon, B. and Hayman, R. (2000). Botulinum toxin type A therapy for palmar and digital hyperhidrosis. Journal of American Academy of Dermatology, 42, 1026–9.CrossRefGoogle ScholarPubMed
Moreau, M., Cauhepe, C., Magues, J. and Senard, J. (2003). Therapeutics: a double-blind, randomized, comparative study of Dysport® vs. BOTOX® in primary palmar hyperhidrosis. British Journal of Dermatology, 149, 1041–5.CrossRefGoogle Scholar
Naumann, M., Zellner, M., Toyka, K. and Reiners, K. (1997). Treatment of gustatory sweating with botulinum toxin. Annals of Neurology, 42(6), 973–5.Google ScholarPubMed
Bjerkhoel, A. and Trobbe, O. (1997). Frey's syndrome: treatment with botulinum toxin. Journal of Laryngology and Otology, 111(9), 839–44.CrossRefGoogle ScholarPubMed
Eckardt, A. and Kuettner, C. (2003). Treatment of gustatory sweating (Frey's Syndrome) with botulinum toxin A. Head and Neck, 25, 624–8.CrossRefGoogle ScholarPubMed
Beerens, A. and Snow, G. (2002). Botulinum toxin A in the treatment of patients with Frey Syndrome. British Journal of Surgery, 89, 116–19.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×