Content » Vol 88, Issue 4

Clinical Report

Cooling by Frozen Gel Pack as Pain Relief During Treatment of Axillary Hyperhidrosis with Botulinum Toxin A Injections

Jette Skiveren, Emmy Kjaerby, Heidi Nordahl Larsen
DOI: 10.2340/00015555-0465


Botulinum toxin A injection is a well-described efficacious treatment for axillary hyperhidrosis. Although considered a safe treatment, many patients experience pain during injections. The purpose of the present study was to examine whether cooling by frozen gel packs applied in the axilla for 5 min before treatment could reduce pain. Thirty-six patients with axillary hyperhidrosis were included in this randomized, open-label prospective study, in which patients were their own controls. Pain was assessed before, during (four times), and immediately after treatment, using a numeric rating scale. The patients experienced statistically significant pain reduction, of 14–19%, in areas cooled by frozen gel pack (p<0.01). However, the clinical relevance of this relatively small pain reduction is questionable.


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