Publication: Fractional CO<inf>2</inf> laser-assisted Botulinum toxin type A delivery for the treatment of primary palmar hyperhidrosis
Issued Date
2020-01-01
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1435604X
02688921
02688921
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2-s2.0-85086576840
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Mahidol University
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SCOPUS
Bibliographic Citation
Lasers in Medical Science. (2020)
Suggested Citation
Natchaya Junsuwan, Woraphong Manuskiatti, Weeranut Phothong, Rungsima Wanitphakdeedecha Fractional CO<inf>2</inf> laser-assisted Botulinum toxin type A delivery for the treatment of primary palmar hyperhidrosis. Lasers in Medical Science. (2020). doi:10.1007/s10103-020-03064-5 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/58261
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Title
Fractional CO<inf>2</inf> laser-assisted Botulinum toxin type A delivery for the treatment of primary palmar hyperhidrosis
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Abstract
© 2020, Springer-Verlag London Ltd., part of Springer Nature. Intradermal injections of botulinum toxin type A (BTX-A) have been used successfully to treat patients with primary palmoplantar hyperhidrosis (PPH). However, problems with local injections of BTX-A for palmar hyperhidrosis include injection pain and reduced palmar muscle strength. This case series describes three patients with PPH. Patients were followed up for 3 months and assessed using the minor iodine starch test and the visual analog scale (VAS). Over two sessions within a 2-week interval, all patients received treatment on one palm, while the other palm served as the untreated control. Treated palms received fractional CO2 laser therapy and immediate post-operative topical application of BTX-A solution for a total of 50 units. Sweat production was assessed based on the size of the sweat-producing area (measured by the minor iodine starch test) and subjective assessment of sweat production using the visual analog scale (VAS) at baseline, 2 weeks after the first treatment, and 1, 2, and 3 months after the second treatment. In the BTX-A-treated palm, the decrease in the mean sweat production was 51.6% at 2 weeks after the first treatment, and 88.5%, 67.8%, and 52.9%, at 1, 2, and 3 months after the final treatment when compared to the baseline. In the untreated palms, the decrease in the mean sweat production was 2% on all follow-ups when compared to the baseline. No adverse effect was observed in any patient. Fractional CO2 laser is a safe technique for BTX-A delivery on the palm area and is demonstrated to be safe and effective in decreasing sweat secretion of hyperhidrosis palm.