Abstract
•Palmar and plantar hyperhidrosis can significantly impact the quality of life.•Botulinum toxin can produce hypohidrosis on the palms and soles for up to 6 months.•Pain control is the greatest challenge for this method of treatment. Ice or cooling devices are well tolerated modes of anesthesia for the hands; regional nerve blocks may also be used.•Injections should be spaced 1 to 1.5 cm apart, with 2 to 3 U of botulinum toxin A per injection site on average.•Success rates are high for palmar hyperhidrosis with variable success for plantar hyperhidrosis despite similar injection techniques.•The most significant complication after botulinum toxin injection for palmoplantar hyperhidrosis is weakness of the hand or fingers, but proper injection techniques can minimize this risk.
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