Focal Hyperhidrosis of the Anal Fold: Successful Treatment with Botulinum Toxin A

BACKGROUND Treatment of focal hyperhidrosis with botulinum toxin A (BTX‐A) is known to be effective in the axillary, palmar, and plantar region. No studies evaluating the treatment of hyperhidrosis in the anal fold with BTX‐A are available, however. OBJECTIVE The objective was to evaluate whether or not injections with BTX‐A are an effective therapy option for the treatment of focal hyperhidrosis of the anal fold. MATERIAL AND METHODS Eleven male patients (median age, 28.3 years) with focal hyperhidrosis of the anal fold as assessed by modified iodine‐starch test were enrolled. Each patient received intradermal injections with 38 U on average (30–54 U) of BTX‐A (BOTOX, Allergan Inc.). Changes in sweat rates were documented by comparing the size of hyperhidrotic area in square centimeters before and 4 weeks after injection. RESULTS The mean reduction of hyperhidrotic area was 29.9 cm2 (range, 27–43 cm2), corresponding to a reduction of 78.5%. Apart from painful injections, no side effects were observed. CONCLUSION BTX‐A is an effective therapy for patients with focal hyperhidrosis of the anal fold.