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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

We read with interest the article by Karamfilov et al¹ suggesting lower relapse rates of hyperhidrosis after high-dose botulinum toxin type A injections (BOTOX; Allergan Inc, Irvine, Calif; hereinafter, generically, botulinum toxin A).¹ Various protocols for treating hyperhidrosis with botulinum toxin A have been issued empirically without controlled comparison of doses, dilutions, number of injections, or pharmaceutical products. Thus, any attempt to provide evidence-based information on how to optimize botulinum toxin A treatment should be welcomed. For this purpose, however, stringent study designs, accurate measurements of sweating, and uniform follow-up schedules are indispensable. Unfortunately, Karamfilov et al¹ did not implement a control group receiving low-dose botulinum toxin A, which could have been easily provided by a left-vs-right comparison, with each patient being his own control.

Also, the iodine-starch test and planometry, which are helpful to visualize the active hyperhidrotic area, are not pertinent for exact quantification of sweating. In fact, . . . [Full Text of this Article]

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