300 Section - Effects of Intradermal Botulinum Toxin Type A Injections on Residual Limb Hyperhidrosis in Amputees: A Retrospective Study

Tuesday, May 19, 2026

6:00 PM - 7:30 PM PT

Presenting Author/Autor expositor(s)

KG

Kelin Gascon-Kimpton, MD

PGY-4 Resident in Physical Medicine and Rehab
Université Laval
Quebec, Quebec, Canada
SA

Sihem Neila Abtroun, MD

PGY-3 Resident in Physical Medicine and Rehab
Université Laval
Candiac, Quebec, Canada

Co-Author/Coautor(s)

MR

Maxime Robert, PhD

Professor
Université Laval
Quebec, Quebec, Canada
AR

Ariane Rajotte-Martel, MD

Physiatrist
Institut de réadaptation en déficience physique de Québec
Quebec, Quebec, Canada
MB

Maude Boucher, n/a

Medical student
Université Laval
Quebec, Quebec, Canada

Objectives : Hyperhidrosis affects up to 72% of lower limb amputees. It can cause skin complications and negatively impact prosthesis use and quality of life. Although botulinum toxin type A (BTX-A) is an effective focal treatment for hyperhidrosis, few studies have evaluated its use for residual limb hyperhidrosis, and most originate from military rehabilitation settings. This study aimed to assess the effects of intradermal BTX-A injections on residual limb hyperhidrosis in a general amputee population.

Design: A retrospective study was conducted in a public outpatient rehabilitation center. Lower limb amputees with hyperhidrosis who received intradermal BTX-A injections were included. The primary outcome was sweating severity before and after injections, measured by the Hyperhidrosis Disease Severity Scale (HDSS) and a Likert scale. Secondary outcomes included the functional impact of hyperhidrosis: comfort (Likert scale), daily prosthesis wear time, and walking time (self-reported). Assessments were performed before and 6–12 weeks after injections and compared using the Wilcoxon signed-rank test.

Results: A total of 17 residual limbs in 15 participants (including two bilateral amputees) were included. Amputation etiologies were traumatic (41.2%), infectious (35.3%), vascular (11.8%), neoplastic (5.9%), and congenital (5.9%). Sweating reduction on the HDSS was 1.80 points (p = 0.002), with 75% of participants reporting perceived improvement. Prosthesis comfort increased by 1.21 points on a 10-point Likert scale (p = 0.017). Walking time increased by 74.9 minutes (p = 0.016), and daily prosthesis wear time increased by 0.54 hours (p = 0.406). No major adverse effects were observed.

Conclusion: Intradermal BTX-A injections significantly reduced residual limb hyperhidrosis and improved comfort and prosthesis use in a heterogeneous amputee population. Larger multicenter studies with diverse injection protocols are thus warranted.