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Journal of the American Podiatric Medical Association
Volume 98 Number 2 156-159 2008
Copyright © 2008 American Podiatric Medical Association

Injectable Botulinum Toxin as a Treatment for Plantar Hyperhidrosis

A Case Study

Tracey C. Vlahovic, DPM *, S. Patrick Dunn, BS *, Jill C. Blau, DPM {dagger} and Caroline Gauthier, DPM {ddagger}

* Temple University School of Podiatric Medicine, Philadelphia, PA.
{dagger} Virtua Health Systems, Camden, NJ.
{ddagger} Cambridge Health Alliance, Cambridge, MA.

Corresponding author: Tracey C. Vlahovic, DPM, Temple University School of Podiatric Medicine, 8th and Race Streets, Philadelphia, PA 19107.

Abstract

Hyperhidrosis is defined as excessive and uncontrollable sweating due to overactivity of the eccrine sweat glands. The first line of treatment for plantar hyperhidrosis consists of conservative therapies such as topical solutions (ie, antiperspirant applications and aluminum chloride preparations) and iontophoresis. When the patient has failed these standard treatments, the other available medical options are rather limited and not well tolerated. Botulinum toxin type A (Botox, Allergan Inc, Irvine, California) is a purified neurotoxin complex approved by the US Food and Drug Administration in 2004 for multiple medical conditions, including severe primary axillary hyperhidrosis that failed conservative topical therapies. Few recent clinical studies have suggested that botulinum toxin is effective in the treatment of plantar hyperhidrosis. In this case study, two patients received intradermal injections of botulinum toxin type A into the plantar aspect of both feet. A 3-month follow-up evaluated the efficacy of botulinum toxin type A by subjectively assessing the amount of residual sweating. In these two patients, botulinum toxin type A was an effective and safe treatment for plantar hyperhidrosis. (J Am Podiatr Med Assoc 98(2): 156–159, 2008)






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