A history of Myasthenia gravis.

Reported allergy or hypersensitivity to any Botulinum toxin preparation.

Active infection in either hand.

Patients who have ever received Botulinum toxin vaccine.

Pregnant or lactating women.

Females unable or unwilling to maintain abstinence or use contraception for 28 days following the injections.

Patients who have previously undergone any vascular surgery on the upper extremity, including surgical sympathectomies.

Current use of any aminoglycoside antibiotic

Efficacy of Botulinum Toxin In Scleroderma-Associated Raynaud's Syndrome