Evidence-based medicine: botulinum toxin in focal hyperhidrosis.

All studies performed so far indicate that BTX-A is a safe and effective treatment for focal hyperhidrosis of the axillae and palms, for gustatory sweating, and for some other rare conditions associated with focal hyperhidrosis. Based on two large well-designed, double-blind, placebo-controlled study there is class 1 evidence for the efficacy of BTX-A in axillary hyperhidrosis, and class 2 evidence for BTX-A in gustatory and palmar sweating (classification according to the Quality Standards Subcommittee of the American Academy of Neurology, 1994). Other indications (forehead sweating, plantar hyperhidrosis, truncal sweating) are only anecdotally reported.