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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 adult Axillary HH

Very Mild
.     OTC antiperspirants and deodorants.

..Mild

A.       15 % AlCl3.6H2O / in a 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

C.       If still not tolerated Secure (glycopyrrolate 1% cream) could be tried

..Moderate

A.       30 % AlCl3.6H2O / in SA gel*

B.       Botox injections 50 units per armpit

C.       Botox injections 50 units per armpit + 30 % AlCl3.6H2O / in SA gel*

D.       Botox injections 100 units per armpit

E.       Botox injections 100 units per armpit + 30 % AlCl3.6H2O / in SA gel*

..Severe

A.      Surgical excision of eccrine axillary glands

B.      Endoscopic Transthoracic Sympathectomy could be indicated especially if there is an
 associated palmar HH

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

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