The comparative effectiveness of suction-curettage and onabotulinumtoxin-A injections for the treatment of primary focal axillary hyperhidrosis: a randomized control trial.

Omer Ibrahim, Rohit Kakar, Diana Bolotin, Michael Nodzenski, Wareeporn Disphanurat, Natalie Pace, Lauren Becker, Dennis P West, Emily Poon, Emir Veledar, Murad Alam

Department of Dermatology, Northwestern University, Chicago, Illinois 60611, USA.

Journal of the American Academy of Dermatology 2013 Jul

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Botulinum toxin injections and suction-curettage have been separately shown to be effective in treating axillary hyperhidrosis but have not been compared in the same patients. We sought to compare effectiveness of suction-curettage versus neurotoxin for the treatment of axillary hyperhidrosis. Each of 20 patients was randomized to receive toxin injections to one axilla and suction-curettage to the contralateral axilla. The primary outcome measure was reduction of sweat rate measured by gravimetry, and the secondary measure was quality of life as measured by a patient-directed questionnaire. At 3 months posttreatment, toxin injections decreased baseline resting sweat production by 72.1% versus 60.4% (P = .29) for suction-curettage, and baseline exercise-induced sweat production by 73.8% versus 58.8% (P = .10). When patients were stratified into the categories of light and heavy sweaters, there was a difference among heavy sweaters, with exercise-induced sweat production lower by 10.48 mg/min or 34.3% (P = .0025) at toxin-treated sites. Compared with suction-curettage, toxin also resulted in greater improvements in quality of life by 0.80 points (P = .0002) and 0.90 points (P = .0017) at 3 and 6 months posttreatment, respectively, as measured by the patient questionnaire. The follow-up period was limited to 6 months. By objective measures 3 months after treatment, neurotoxin injections are nominally more effective than suction-curettage in all cases, and markedly more effective in heavy sweaters. Patients have a very significant preference for neurotoxin injections at 3 months, and this is maintained at 6 months. Copyright © 2013 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Citation

Omer Ibrahim, Rohit Kakar, Diana Bolotin, Michael Nodzenski, Wareeporn Disphanurat, Natalie Pace, Lauren Becker, Dennis P West, Emily Poon, Emir Veledar, Murad Alam. The comparative effectiveness of suction-curettage and onabotulinumtoxin-A injections for the treatment of primary focal axillary hyperhidrosis: a randomized control trial. Journal of the American Academy of Dermatology. 2013 Jul;69(1):88-95