Table 5.

Double blind palmar hyperhidrosis studies comparing toxin vs. placebo.

Author & Year	N	Class	Agent	Dose	Primary outcome	Result	Side effects
Schnider et al., 1997 [12]	11	II	A/Abo	120 U	DNSS	Mean reduction in sweat production: 26%, 26%, and 31% at w 3, 8, 13 (p < 0.001) and improvement in VAS 38%, 40%, and 35% at w 3, 8, 13 respectively (p = 0.002) for A/Abo group.	Minor , reversible weakness of handgrip lasting between 2 and 5 w, and minor hematoma at injection site
Lowe et al., 2002 [25]	19	II	A/Ona	100 U	Sweat production (gravimetric measurement) and physician’s and patient’s rating of severity. Safety evaluations via grip strength	Mean percentage change from baseline was significantly greater in the A/Ona-treated palms than in the PBO-treated palms at day 28 (p = 0.0037). Similar results found for Minor’s test.	Finger tingling and numbness in one A/Ona patient. One PBO patient with weakness of injected hand, one patient bilateral hand pain.
Baumann et al., 2005 [18]	20	II	B/Rima	5000 U	Efficacy, duration, safety, and patient and investigator assessment	Patient assessed efficacy showed significant difference in favor of B/Rima through day 120. Physician assessment did not show difference at day 30. Mean duration of effect; 3.8 months. Onset of effect: within 1 w.	Transient dry mouth in 18. Indigestion, dry hands. Muscle weakness in 12. Decreased grip strength in 10.

A/Ona: Onabotulinumtoxin A (Botox); A/Inco: incobotulinumtoxinA (Xeomin); A/Abo: abobotulinumtoxinA (Dysport); B/Rima: RimabotulinumtoxinB (Myobloc); DNSS: digitized ninhydrin-stained sheets; VAS: Visual Analogue Scale; SAE: Serious Adverse Effect; GATS: Patients Global assessments of treatment satisfaction; PBO: placebo; QOL: Quality of life; HDSS: Hyperhidrosis Disease Severity Scale; w: week(s).