Jet injection of Botox effective for palmar hyperhidrosis
Botox treatment using a needle-free jet injection was effective in treating palmar hyperhidrosis compared with traditional needle injection, according to recently published study results.
Researchers in Montreal conducted a prospective, open-label study with 20 patients (13 female; average age, 31.85 years) with severe idiopathic palmar hyperhidrosis between April 2014 and June 2014.
Patients’ right hands were injected with 1% lidocaine using a jet injector, followed by Botox (onabotulinumtoxinA, Allergan), which was injected with a 33-gauge needle in 50 sites on the hand. OnabotulinumtoxinA was injected directly into the left hand through a needle-free jet injector (Med-Jet MBX, Medical International Technologies).
The techniques were measured for pain. Hyperhidrosis Disease Severity Scale (HDSS) was used to measure severity of palmar hyperhidrosis at 0, 1, 3 and 6 months.
HDSS score reduction of at least 1 at 1-month follow-up was primary outcome. There was no statistical difference between both hands in 1-point reduction at 1 month. There was a drop of 1.6 in HDSS score for the hand with needle-treated onabotulinumtoxinA hand compared with 1.25 for the jet-treated hand (P = .031).
In patients’ comparisons of hands, most preferred the direct injection of onabotulinumtoxinA by jet injection.
Mean pain on injection was tolerable and comparable for both techniques, with pain scores of 2.75 for needle treatment and 3.025 for jet treatment without lidocaine.
“Treatment of severe palmar [hyperhidrosis] with direct injection of [onabotulinumtoxinA] with a needle free device was found to be effective,” the researchers wrote. “Nevertheless [onabotulinumtoxinA] injection directly with the needle-free injector appears less efficacious than [onabotulinumtoxinA] injection with needle. Still, in a needle-phobic patient, the authors consider this technique as a promising alternative.” – by Bruce Thiel