Ectopic Sweating Treated with Botulinum Toxin after Vapocoolant Spray

Hyperhidrosis is most often characterized by excessive sweating of the axillae, palms, soles, and craniofacial area. BTX-A injections for the treatment of hyperhidrosis have shown good results in the afflicted areas. However, few studies have reported on the effects of the use of BTX-A injections using vapocoolant spray combined vibration techniques in the facial area, perianal and groin area, or scrotum. BTX-A 0.8 units/0.1 mL and 2 units/0.1 mL were injected in these region, respectively, using a 33G needle. As a result, sweating was significantly reduced in all patients. Side effects observed with this treatment modality consisted of local bleeding and tolerable to mild pain during injection.