Neuromuscular Blocking Agents

These agents block acetylcholine and inhibit the transmission of nerve impulses that trigger sweating. Botulinum toxin (Botox®) is injected under the skin and produces a sustained, localized decrease in sweating. It may be used to treat underarm, palm and sole hyperhidrosis.

Each injection produces an area of dryness approximately 1.2 cm in diameter for a number of months.

Underarm treatments are well tolerated but injections to the thicker skin of the palm and soles of the feet may be painful and may require a regional nerve block to produce local anesthesia.

Here are some quick facts on Botox® injections;

• FDA indicated and HPB approved in Canada for axillary hyperhidrosis
• Blocks acetylcholine release from nerve endings, thus sweat gland not stimulated
• Highly effective (more than 90%)
• Effect is transient (7.8 month average, 40% more than a year)
• Effective for axillae, palms, plantar, face and other localized areas
• Side effects rare for axillae other than local mild discomfort during injection and rare flu like symptoms
• For hands: nerve blocks with rare median nerve injury risk, intrinsic hand muscle weakness in some people (transient)
• Facial muscle paralysis can be a result of facial hyperhidrosis treatment with Botox®
• Costly - Drug alone: C$400 for axillae, $800 for palms and $1600 for plantar surface per treatment