Increasing the Field Effects of Similar Doses of Clostridium botulinum Type A Toxin–Hemagglutinin Complex in the Treatment of Compensatory Hyperhidrosis

H yperhidrosis (HH) is characterized by excessive sweating, usually exceeding thermoregulatory needs. Medical and surgical treatments can be used, depending on the type, location, and severity of the HH. Thoracic sympathectomy is indicated for selected cases of severe palmar HH, but the procedure may result in troublesome compensatory HH (CHH). Injections of botulinum toxin type A can temporarily interrupt sweating, and this new therapeutic option has emerged as a treatment for many forms of focal HH, including CHH. Because the diameter of the field effects (FEs) resulting from the injection of botulinum toxin type A is about 2 cm, a number of injections are needed to treat different forms of HH. Herein, we describe a series of 3 women with CHH of the trunk occurring after thoracic sympathectomy. All 3 patients were treated with 5 U of Clostridium botulinum type A toxin–hemagglutinin complex (hereinafter “Dysport”; Ipsen Limited, Slough, England) at different dilutions and injected at different depths.