We found no RCT. The largest case series so far compared subcutaneous curettage (n = 90) with injection of botulinum toxin A (n = 20), and reported equally good results for both interventions.10 Sixty-seven per cent of patients reported a good or very good outcome after subcutaneous curettage in this study. Hasche et al15 reported a reduction of the area of sweating as shown by the starch iodine test. However, no quantitative efficacy data were reported. Subjectively, 18 of 20 patients considered that the intervention had led to good results.

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