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Botulinum toxin type A is a neurotoxic protein produced by the bacterium *Clostridium botulinum*. In the specific clinical application studied by the University of California, Davis for palmar hyperhidrosis, the toxin is applied topically to the palms following pretreatment with microneedles. The microneedles create micro-channels in the stratum corneum to facilitate transdermal delivery of the toxin to the eccrine sweat glands, aiming to provide an effective treatment with significantly less pain than traditional intradermal injections. The toxin functions as a zinc-dependent endopeptidase that specifically cleaves synaptosomal-associated protein 25 (SNAP-25), a member of the SNARE protein complex required for vesicle fusion. By disrupting this complex, the toxin inhibits the presynaptic release of acetylcholine at sympathetic cholinergic nerve endings, thereby reducing excessive sweat production.
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