Two case reports on the use of intradermal botulinum toxin A in the treatment of scalp hyperhidrosis were presented, with a focus on the quality of life measured by the Dermatology Quality of Life Index (DLQI). In one patient the DLQI fell from 14 to 3 after 1 month. Treatment with botulinum toxin A is expensive but may be worthy of further study in this distressing condition (Birnie, A. and Motley, R.J. Br J Dermatol 2009, 161 (Suppl. 1): 106, Abst DS-15).