How Painful Are Botox Injections for Underarm Hyperhidrosis?

I am considering Botox for underarm perspiration but I would like to know, how much pain would be associated with doing that?

Doctor Answers 20

Miradry instead!

Our office specializes in Miraday. Miradry just got FDA clearance for elimination of all hair colors under the arm. It also has clearance for the elimination of underarm sweating and odor. Much cheaper than botox and permanent.

Beverly Hills Plastic Surgeon
5.0 out of 5 stars 29 reviews

Botox injections under the armpit are comfortable, but well tolerated

You will receive about 20 injections with a fine-gauged needle into each armpit.  Each injection feel a bit like a mosquito bite.  There is no pain once the needle is withdrawn.

You may also want to consider MiraDry, a noninvasive, in-office procedure. It destroys sweat glands using microwave technology. Patients typically have a >90% reduction with just one treatment. We pretreat the armpits with injectable lidocaine.  This is uncomfortable for a few moments.  After the procedure, when the numbing medication wears away, patients do have swelling and mild discomfort that lasts for 24 hours to a few days.

Botox for underarm hyperhidrosis, painful?

Botox has been FDA approved for Axillary hyperhidrosis since 2004.

In our office, we apply a topical numbing medicine.  The procedure is quick, using a very small needle.  Most of our patients tolerate it well, and often say it is not a "big deal." 

We have had good experience with Botox injections to the armpits. We have treated patients, staff, and family members. We typically use 50 units per armpit. I have had a couple of patients tell me it is the first time they wore a powder blue shirt in years. The red carpet models also like to do this before big events.

Jeffrey Roth, MD
Las Vegas Plastic Surgeon
4.5 out of 5 stars 12 reviews

Pain With Botox Injections At Underarms

Most patients seem to tolerate Botox injections at the underarms very well. The needle used is small and the treatment is quick, despite the number if injections delivered. A topical anesthetic cream can be used to help alleviate some of the discomfort. Sometimes a cold pack can do the trick as well. This treatment is very effective in reducing excessive sweating for 3-6 months.

Not very painful, but numbing gel can make this almost painless

Think of the procedure as tiny ant bites, but over 20-25 on each armpit. We usually inject both arms at the same time to speed up the process. In the scheme of things, 95% of patients tolerate the procedure without any problems, some find it painful. Remember pain is very subjective. 

This is how I deal with things- if you had the procedure before, or if you have a low pain threshold (nothing to be worried about), come in 30 minutes early and we sit you in a quiet room with some 23/7 gel on. This takes away 80% of the pain, in some cases 100%.

Pain is the least problematic stumbling block of getting Botox for excessive sweating. 


Dr Davin Lim

Davin Lim, MBBS, FACD
Brisbane Dermatologist
5.0 out of 5 stars 19 reviews

Botox for underarm sweating

Botox for underarm sweating is not very painful. We use very small caliber needle for injections. The actual injection is very superficial and you can expect up to 20 injections per side. It is very effective against underarm sweating and you can expect the results to last about 6 months.  

Kyle S. Choe, MD
Virginia Beach Facial Plastic Surgeon
4.5 out of 5 stars 27 reviews

Botox for Underarm Hyperhidrosis

For most patients, Botox injections do not hurt although you might feel slight discomfort. Your doctor should be able to provide you with a topical anesthetic prior to underarm injections if you are worried about pain or discomfort.

Mitchel P. Goldman, MD
San Diego Dermatologic Surgeon
4.5 out of 5 stars 7 reviews

Botox for Hyperhidrosis - Painful?

Botox injections use very fine guage needles so not very painful, certainly not afterward. The average costs depends on the number of units injected and the area. To minimize discomfort topical anesthetics can be applied before hand as well as ice packs.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 72 reviews

It is not painful

most patients do fine since a very small needle is used. if you are worried, then have your doctor give you a numbing cream.

the results are very good from Botox. in my experience it has lasted longer than 6 months.

For a much longer lasting result, you should consider Cellulaze off label use of the laser. i have been very pleased. takes 30 minutes in my office under local only.

david berman md

board certified plastic surgeon.

northern va

David E. Berman, MD
Sterling Plastic Surgeon
5.0 out of 5 stars 29 reviews

Options for Miradry or Botox for armpit sweating in Los Angeles

I believe that the clinical benefits of Miradry demonstrated over the past two years make it a very good alternative to Botox for the axilla and armpits. Raffy Karamanoukian, Los Angeles

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 70 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.