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Needle-free anesthesia: a promising technique for the treatment of palmoplantar hyperhidrosis with botulinum toxin A

Antranik Benohanian

Botulinum toxin type A (BTX-A) has recently emerged as an effective therapeutic option to control palmar hyperhidrosis. The main problem with this treatment is the intense pain felt by the patient during the penetration of the needle to inject BTX-A into the densely innervated skin of the palm. Injection of needle-free lidocaine, delivered through a needle-free device, the MED-JET® MBX by Medical International Technologies Inc. Canada, renders the BTX-A injections almost painless. The mixture of lidocaine and BTX-A does not jeopardize toxin potency. Needle-free anesthesia prior to BTX-A injection with a needle is an emerging technique that may encourage more clinicians to treat palmoplantar hyperhidrosis.