A double-blind, randomized, comparative study of two type A botulinum toxins in the treatment of primary axillary hyperhidrosis.

Background: Botulinum toxin (BTX) is an effective treatment for primary axillary hyperhidrosis. In this study we used two toxins not bioequivalent: BOTOX (Allergan, Inc.) and Dysport (Beaufour Ipsen Biotech).

Objective: The objective was to compare the efficacy, safety, and tolerability of BOTOX and Dysport in the treatment of primary axillary hyperhidrosis using a conversion factor of 1:3, respectively.

Methods: In a double-blind, randomized prospective study, 10 patients with primary axillary hyperhidrosis and sweat production exceeding 50 mg/minute received 50 U of BOTOX in one axilla and 150 U of Dysport in the other. We performed Minor's test and gravimetry at 0 days, at 15 days, and monthly for 1 year.

Results: No significant difference was observed in the sweating quantity at baseline. After 1 month all patients had achieved success for both axillae. The sweat rate was reduced by a mean of 97.7% for BOTOX and 99.4% for Dysport, without statistical difference. The duration of benefits was similar between both toxins, with a mean of 260 days for BOTOX and 290 days for Dysport, without statistical difference. The longest symptom-free interval was 12 months (5 patients, 55.6%).

Conclusions: BOTOX and Dysport presented similar levels of safety and efficacy in the treatment of primary axillary hyperhidrosis when a conversion factor of 1:3 was used.