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Sweaty feet in adolescents—Early use of botulinum type A toxin in juvenile plantar hyperhidrosis

2018; Wiley; Volume: 35; Issue: 6 Linguagem: Inglês

10.1111/pde.13628

1525-1470

Matthias K. Bernhard, Matthias Krause, Steffen Syrbe,

Sympathectomy and Hyperhidrosis Treatments

Abstract Background/Objectives Plantar hyperhidrosis can have severe social effects on children and adolescents. Therapeutic options include antiperspirants and surgical interventions (eg, sympathectomy). Botulinum type A toxin is approved for axillary hyperhidrosis in adults only. The aim of the study was the determination of effect and safety of botulinum type A toxin in plantar hyperhidrosis in juvenile patients. Methods Children and adolescents with idiopathic focal plantar hyperhidrosis were treated with 50‐100 U of botulinum type A toxin per sole. Local anesthesia was provided using topical eutectic mixture of local anesthetics cream and ice, in combination with midazolam as an anxiolytic. Results Fifteen patients (aged 12‐17) were included in the study. Best results were achieved with a dose of 75‐100 U of botulinum type A toxin per sole. Two patients did not benefit from the therapy, and 11 (73%) were satisfied with the results. Nine patients (60%) experienced pain at the injection site for a maximum duration of 3 days. One patient reported transient focal weakness for 4 weeks. Conclusion Botulinum type A toxin seems to be a safe secondary treatment option for plantar hyperhidrosis in adolescents aged 12 and older. A dose of 75‐100 U per sole resulted in a good therapeutic effect of variable duration in most patients. There were no severe side effects.