Effectiveness, safety and tolerability of botulinum toxin in focal hyperhidrosis and dynamic facial wrinkles


  • K. Gopalakrishnan Department of Dermatology, SRM Institute of Science and Technology, Kancheepuram, Tamil Nadu, India




Intra dermal botulinum toxin, Palmar hyperhidrosis, Dynamic facial wrinkles


Background: Botulinum toxin is a potent neurotoxin that inhibits the release of acetylcholine at the neuromuscular junction thereby causing localized muscle relaxation which smoothen the overlying skin and reduces dynamic facial wrinkles. Also clinical studies suggest that intra dermal injections of botulinum toxin are effective in the treatment of palmar hyperhidrosis by blocking the excessive sympathetic cholinergic sudomotor nerve traffic to the palmar surface of the hands.

Methods: We treated twenty patients with palmar hyperhidrosis and fifteen patients with dynamic facial wrinkles with intra dermal botulinum toxin type A.

Results: Among patients treated, complete response was seen in 90% of patients with hyperhidrosis and 70% for patients with facial wrinkles. The relapse of symptoms was highly variable among patients and the average relapse was seen at 14 weeks for both the indications. No major side effects noted.

Conclusions: Botox is an effective and highly tolerable treatment for both hyperhidrosis and facial wrinkles.

Author Biography

K. Gopalakrishnan, Department of Dermatology, SRM Institute of Science and Technology, Kancheepuram, Tamil Nadu, India




Erbguth FJ. Historical notes on botulism, Clostridium botulinum, botulinum toxin, and the idea of the therapeutic use of the toxin. J Movement Disorders. 2004;20:12–6.

vanErmengem EP. Uebereinenneuenanaëroben Bacillus und seine BeziehungenzumBotulismus (in German). Zeitschriftfür Hygiene und Infektionskrankheiten. 1985;26:1–56.

Tessmer SP, Sommer H. Studies on Botulinus Toxin. Acid Precipitation of Botulinus Toxin. J Infect Dis. 1943;2:152–60.

Burgen ASV, Dickens F, Zatman LJ. The Journal of Physiology. 1949;10:10–24

Connolly M, de Berker D. Management of primary hyperhidrosis: a summary of the different treatment modalities.Am J Clin Dermatol. 2003;4:861-97.

Wollina U, Karamfilov T. Botulinum toxin A for palmar hyperhidrosis. J Eur Acad Dermatol Venereol. 2001;15(6):555-8.

Lowe N, Lask G, Yamauchi P. Efficacy and safety of botulinum toxins A and B, for the reduction of glabellarrhytids in female subjects. JAAD. 2002;28(9):822-7.

Blitzer A, Brin MF, Keen MS, Aviv JE. Botulinum toxin, for the treatment of hyperfunctional lines of the face. Arch Otolaryngol Head Neck Surg. 1993;119:1018-22.

Carruthers J, Stubbs HA. Botulinum toxin for benign essential blepharospasm, hemifacial spasm and age-related lower eyelid ectropion. Can J Neurol Sci. 1987;14:42-5.

Fagien S. Botox for the treatment of dynamic and hyperkinetic facial lines and furrows - Adjunctive use in facial aesthetic surgery. Plast Reconstr Surg. 2003;112:40-52.






Original Research Articles