Abstract
ABSTRACT: Primary focal hyperhidrosis can cause lifelong distress in everyday activities. Some patients cannot adequately decrease excessive perspiration with over-the-counter or prescription-strength antiperspirants. Oral glycopyrrolate is an anticholinergic medication that can decrease perspiration but may also lead to intolerable systemic side effects. Botulinum toxin injected into the axilla provides immediate symptomatic relief that lasts for approximately 6 months. Offering patients botulinum toxin as a second-line agent for treatment-resistant axillary hyperhidrosis can markedly improve quality of life with minimal side effects.