Comparison of intradermal injection with iontophoresis of abobotulinum toxin A for the treatment of primary axillary hyperhidrosis: A randomized, controlled trial

Abstract

Background: Botulinum neurotoxin type A (BTX-A) injection is the treatment of choice for idiopathic axillary hyperhidrosis (IAH) refractory to conventional treatments. Objective: This study compared the efficacy of BTX-A injection and iontophoresis for treatment of IAH in a randomized controlled trial. Methods: In eleven patients with the diagnosis of IAH, one axilla was randomly treated with injections of 1.5 mL (250 MU) of BTX-A, and the other side was treated with BTX-A administered by iontophoresis. The amount of sweating, skin hydration, transepidermal water loss, pain, and patient satisfaction on both axilla were compared with baseline levels, and also between both sides 1 week, 1 month, and 6 months after treatment. Results: The injection side had significantly less sweat production than the iontophoresis side 1 week, 1 month, and 6 months after treatment (84%, 76%, and 50% vs. 73%, 22%, and 32%, respectively). The response to iontophoresis was more stable than that to injection. Participants' pain perception during the procedure score was significantly less on the iontophoresis side compared with the injection side (15.0 vs. 20.0, p < 0.05). Conclusion: This study has shown that injection is a more effective method for the administration of BTX-A, though iontophoresis can also be considered a non-invasive and painless method in some patients.

Key words::

• iontophoresis
• axillary hyperhidrosis
• botulinum toxin A

Acknowledgement

This study was fund supported by (research grant no. 10021) the Undersecretary of Research, Tehran University of Medical Sciences. We also thank Nicholas Knoblauch, a research assistant in the pathology department at the Beth Israel Deaconess Medical Center, Boston, MA, USA.