Comparative study of 20% aluminum chloride solution and botulinum toxin A injection in the treatment of patients with primary palmar hyperhidrosis

Background: Primary hyperhidrosis carries a substantial psychological and social burden. Early detection and management can significantly improve a patient's quality of life. A large number of therapeutic options are used, such as the application of topical agents, iontophoresis, sympathectomy, and botulinum toxin injection. Objective: We aim to comprehensively evaluate the effects of botulinum toxin type A and 20% aluminum chloride on primary palmar hyperhidrosis. Methods: A total of 55 patients with clinical diagnosis of primary hyperhidrosis were treated by botulinum toxin type A and 20% aluminum chloride solution. To prospectively assess the effects on primary palmar hyperhidrosis, we checked comeometer at baseline, 2 and 4 months later. By regular meetings with patients, including telephone interviews, we analyzed patients' subjective satisfaction scores and complaints during the follow-up periods. Results: During the 2-month period, as compared with that of the control group, the level of comeometer of both groups declined. In the 4-month period, the group treated with 20% aluminum chloride sustained a lower level of comeometer. In the questionnaire, in the 2-month period, the group treated with botulinum toxin resulted in a lower level of overall treatment scores than that of the group treated with 20% aluminum chloride. However, in the 4-month period, the group treated with aluminum chloride showed lower scores. Conclusion: Both botulinum toxin type A and aluminum chloride solution were safe and well tolerated, producing high levels of patient satisfaction. However, considering the long-term efficacy of treatment, aluminum chloride may be a more suitable mode of treatment for primary palmar hyperhidrosis.