Fig. 2: Intradermal botulinum toxin injections for the treatment of axillary hyperhidrosis. Focal axillary hyperhidrosis is treated with 50–200 units of botulinum toxin A per axilla. The usual starting dose is 50 units per axilla. The drug is injected intradermally using a 13-mm-long 30-gauge needle. Injections are done in a grid-like pattern in order to cover the entire affected area, with injection sites generally 1–2 cm apart. There is no difference in efficacy of botulinum toxin A in the treatment of axillary hyperhidrosis when administered by subcutaneous or intradermal injection, but intradermal injections are reported to be more painful.³³The subcutaneous injection technique requires further study for validation of the results.