Hyperocclusive technique for topical anesthesia for injecting botulinum toxin in palmar hyperhidrosis

Abstract

Injecting botulinum toxin under simple topical anesthesia using a eutectic mixture of lignocaine and prilocaine is a painful procedure. A simple hyper-occlusive modification in the existing technique of topical anesthesia of palms facilitates painless injections leading to greater patient satisfaction and compliance.

Keywords: Botulinum toxin; Hyperhidrosis; Hyperocclusion; Topical anesthesia.

Figure 1:

Application of thick layer of lignocaine-prilocaine mixture followed by occlusion by double surgical gloves for two sessions of 1 hour each.

Figure 2:

Visible maceration of palmar surface achieved after 2 hours, which facilitates easy injection of botulinum toxin.