Pain Control during the Treatment of Primary Palmar Hyperhidrosis with Botulinum Toxin A by a Topical Application of Liposomal Lidocaine: Clinical Effectiveness

Primary palmar hyperhidrosis (PPH) constitutes a debilitating condition that profoundly impacts the social, functional, and occupational aspects of individuals. The intradermal administration of botulinum toxin type A (BoNT-A) stands as an established therapeutic approach for PPH, albeit one frequen...

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Main Authors: Andrea Marani, Helena Gioacchini, Matteo Paolinelli, Ivan Bobyr, Emanuela Martina, Giulia Radi, Federico Diotalallevi, Anna Campanati
Format: Article
Language:English
Published: MDPI AG 2024-01-01
Series:Toxins
Subjects:
Online Access:https://www.mdpi.com/2072-6651/16/1/28
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author Andrea Marani
Helena Gioacchini
Matteo Paolinelli
Ivan Bobyr
Emanuela Martina
Giulia Radi
Federico Diotalallevi
Anna Campanati
author_facet Andrea Marani
Helena Gioacchini
Matteo Paolinelli
Ivan Bobyr
Emanuela Martina
Giulia Radi
Federico Diotalallevi
Anna Campanati
author_sort Andrea Marani
collection DOAJ
description Primary palmar hyperhidrosis (PPH) constitutes a debilitating condition that profoundly impacts the social, functional, and occupational aspects of individuals. The intradermal administration of botulinum toxin type A (BoNT-A) stands as an established therapeutic approach for PPH, albeit one frequently accompanied by considerable pain, posing challenges for patient tolerance. Our study aimed to assess the efficacy of combining cryoanalgesia spray (CA) with topical anesthesia utilizing a cream containing liposomal lidocaine at a concentration of 40 mg/g, with the objective of mitigating the pain associated with intradermal BoNT-A injection for PPH treatment. Nineteen participants, aged ≥18 years and afflicted with severe PPH, were enrolled in a double-blind randomized vehicle-controlled trial. Patient-perceived pain during the procedure was quantified using the Numeric Rating Scale (NRS). Statistical analysis was applied to the collected data. The combination of CA and the topical application of liposomal lidocaine during BoNT-A treatment for PPH resulted in diminished pain compared to CA alone and the combination of CA with the application of a basic cream. Topical anesthesia through the application of a liposomal lidocaine-containing cream emerged as a facile, secure, and efficacious approach for alleviating the pain associated with intradermal BoNT-A injection in PPH treatment. Furthermore, it demonstrated compatibility with CA, thereby offering a comprehensive strategy for pain management during BoNT-A administration.
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spelling doaj.art-763a6c6636d248578ede9cd6a5d03a612024-01-26T18:42:26ZengMDPI AGToxins2072-66512024-01-011612810.3390/toxins16010028Pain Control during the Treatment of Primary Palmar Hyperhidrosis with Botulinum Toxin A by a Topical Application of Liposomal Lidocaine: Clinical EffectivenessAndrea Marani0Helena Gioacchini1Matteo Paolinelli2Ivan Bobyr3Emanuela Martina4Giulia Radi5Federico Diotalallevi6Anna Campanati7Clinic of Dermatology, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60126 Ancona, ItalyClinic of Dermatology, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60126 Ancona, ItalyDermatology Unit, “Infermi” Hospital of Rimini, 47900 Rimini, ItalyClinic of Dermatology, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60126 Ancona, ItalyClinic of Dermatology, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60126 Ancona, ItalyClinic of Dermatology, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60126 Ancona, ItalyClinic of Dermatology, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60126 Ancona, ItalyClinic of Dermatology, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60126 Ancona, ItalyPrimary palmar hyperhidrosis (PPH) constitutes a debilitating condition that profoundly impacts the social, functional, and occupational aspects of individuals. The intradermal administration of botulinum toxin type A (BoNT-A) stands as an established therapeutic approach for PPH, albeit one frequently accompanied by considerable pain, posing challenges for patient tolerance. Our study aimed to assess the efficacy of combining cryoanalgesia spray (CA) with topical anesthesia utilizing a cream containing liposomal lidocaine at a concentration of 40 mg/g, with the objective of mitigating the pain associated with intradermal BoNT-A injection for PPH treatment. Nineteen participants, aged ≥18 years and afflicted with severe PPH, were enrolled in a double-blind randomized vehicle-controlled trial. Patient-perceived pain during the procedure was quantified using the Numeric Rating Scale (NRS). Statistical analysis was applied to the collected data. The combination of CA and the topical application of liposomal lidocaine during BoNT-A treatment for PPH resulted in diminished pain compared to CA alone and the combination of CA with the application of a basic cream. Topical anesthesia through the application of a liposomal lidocaine-containing cream emerged as a facile, secure, and efficacious approach for alleviating the pain associated with intradermal BoNT-A injection in PPH treatment. Furthermore, it demonstrated compatibility with CA, thereby offering a comprehensive strategy for pain management during BoNT-A administration.https://www.mdpi.com/2072-6651/16/1/28palmar hyperhidrosisanesthesiabotulinum toxincryoanalgesialidocaineNRS scale
spellingShingle Andrea Marani
Helena Gioacchini
Matteo Paolinelli
Ivan Bobyr
Emanuela Martina
Giulia Radi
Federico Diotalallevi
Anna Campanati
Pain Control during the Treatment of Primary Palmar Hyperhidrosis with Botulinum Toxin A by a Topical Application of Liposomal Lidocaine: Clinical Effectiveness
Toxins
palmar hyperhidrosis
anesthesia
botulinum toxin
cryoanalgesia
lidocaine
NRS scale
title Pain Control during the Treatment of Primary Palmar Hyperhidrosis with Botulinum Toxin A by a Topical Application of Liposomal Lidocaine: Clinical Effectiveness
title_full Pain Control during the Treatment of Primary Palmar Hyperhidrosis with Botulinum Toxin A by a Topical Application of Liposomal Lidocaine: Clinical Effectiveness
title_fullStr Pain Control during the Treatment of Primary Palmar Hyperhidrosis with Botulinum Toxin A by a Topical Application of Liposomal Lidocaine: Clinical Effectiveness
title_full_unstemmed Pain Control during the Treatment of Primary Palmar Hyperhidrosis with Botulinum Toxin A by a Topical Application of Liposomal Lidocaine: Clinical Effectiveness
title_short Pain Control during the Treatment of Primary Palmar Hyperhidrosis with Botulinum Toxin A by a Topical Application of Liposomal Lidocaine: Clinical Effectiveness
title_sort pain control during the treatment of primary palmar hyperhidrosis with botulinum toxin a by a topical application of liposomal lidocaine clinical effectiveness
topic palmar hyperhidrosis
anesthesia
botulinum toxin
cryoanalgesia
lidocaine
NRS scale
url https://www.mdpi.com/2072-6651/16/1/28
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