Ann Dermatol Vener
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Hyperhidrosis is considered as an handicap which affects around of 2.8% of the population. It is linked to an extreme, permanent and symetric production of sweating because of an hyperactivity of sweat glands independant of thermo regulation process. ⋯ It is an easy, quick, efficient treatment which improved quality of life of these patients. This treatment can also be used for palmar and plantar hyperhidrosis but it requires regional anesthetic technics, so it is done to the hospital.
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Men are showing increasing interest in nonsurgical esthetic procedures even if women account for the vast majority of patients. Botulinum toxin A injections are particularly sought by men: this is the most frequently performed nonsurgical procedure, with 296,000 injections in the US in 2007 (Fig. 1). ⋯ However, they often require larger doses. In addition, men's facial morphology presents certain specificities that must be respected when choosing the injection points.
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Botulinum toxin could represent nowadays a new treatment modality especially for cutaneous conditions in course of which conventional treatments remain unsuccessful. Besides palmar and plantar hyperhidrosis, botulinum toxin has demonstrated efficacy in different conditions associated with hyperhidrosis, such as dyshidrosis, multiple eccrine hidrocystomas, hidradenitis suppurativa, Frey syndrome, but also in different conditions worsened by hyperhidrosis such as Hailey-Hailey disease, Darier disease, inversed psoriasis, aquagenic palmoplantar keratoderma, pachyonychia congenital. Moreover, different cutaneous conditions associated with sensitive disorders and/or neurological involvements could benefit from botulinum toxin, for example anal fissures, leg ulcers, lichen simplex, notalgia paresthetica, vestibulitis. Endly, a case of cutis laxa was described where the patient was improved by cutaneous injections of botulinum toxin.
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Long-term BoNT treatment administration has been assessed in various treatment settings (especially in neurology), with the level and duration of BoNT efficacy response being maintained with no major safety problems. Most side effects are local one and are transient. The incidence of antibody development is low and does not induce significant concerns in clinical practice.