Botox or Dysport Units for Hyperhidrosis Treatment?

How many units of Botox or Dysport are needed on average in each armpit to block excessive sweating? Also, can I expect my treatment to last 3-4 months like it does on the face? Thanks!

Doctor Answers 18

100 units of botox or 300 units of dysport to temporarily stop armpit sweating

A good starting point is 100 units of botox (50 units per armpit) or 300 units of dysport (150 units per armpit).  Most patients, even heavy sweaters, will get relief from this dosing.  If there is "breakthrough sweating" or if the results are short lasting (less than six months), it is reasonable to increase the dosing incrementally. 

You may also want to consider miraDry.  MiraDry is a noninvasive procedure that is done in the office. It destroys sweat glands using microwave technology. Patients typically have a >90% reduction with just one treatment. It costs about $2000.

Botox/Dysport Units to Treat Hyperhidrosis

Usually the amount of Botox used to treat hyperhidrosis is 50 units per axilla and the amount of Dysport is normally 150 units per axilla. This can vary depending on how large the area is and how much you sweat. The treatment normally lasts anywhere from 3-6 months on average. If the treatment only lasts about 3 months for you, you may need more units. It is always best to have a consultation with a physician in order to determine if you are a candidate for treatment and how much you will need.

Depends on how large the area of sweating

I can only comment on BOTOX as this is the only drug that is subsidised for the treatment of excessive underarm sweating in Australia. Here, Medicare and PBS authorises the use of 100 units, ie 50 units each underarm. On average, patients will have 4-7 months out of this. What is silly, is that we do NOT have the flexibility to give more or less units under the subsidy scheme (in Australia that is.). Namely, an armpit the size of a adult's hand receives the same amount (50 Units) as some one who sweats profusely out a one square inch area. Sounds silly, and it is illogical. 

To answer your specific question, the average user needs 50 units, IMO, some patients can get away with 20 units to each armpit, and others need 70 units. One size glove does not fit all, and seeing an experienced dermatologist can guide you the the least amount of units for the MAXIMAL benefit. 

Hope this helps 

Dr Davin Lim 

Laser and aesthetic dermatologist
Hyperhidrosis expert
Brisbane, Australia

Davin Lim, MBBS, FACD
Brisbane Dermatologist
5.0 out of 5 stars 9 reviews

Botox or Dysport Units for Hyperhidrosis Treatment?

Botox and Dysport is a great option and highly effective helping excessive sweating, most patients require 50 units per axilla with Botox or 150 units per axilla with Dysport. Its best to seek a reputable provider with much experience in treating Hyperhidrosis

Botox versus Dysport For Hyperhidrosis

Botox and Dysport both are good choices for hyperhidrosis.  I prefer Botox toxin as I have more experience with this agent for this application.  The dosage is based on the surface area needed for injection.  

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
5.0 out of 5 stars 94 reviews

Botox and Dysport units for hyperhidrosis

I would recommend starting with 50 units of Botox or 150 units of Dysport (3:1 ratio of Dysport:Botox).  This would provide anywhere from a 3-6 months relief.  If you find that it lasts closer to 3 months, then I would increase the dosage the subsequent visit to see if I could get more longevity.  

Fortunately an Easy Answer...

almost by convention 50 units of botox under each arm is the way to begin...so a total of 100 units altogether...some people may need a bit more but overwhelmingly this dose is a good bet for average sized people...and the effects generally last between 6-12 months with an average closer to 9 months...imagine how nice it would be not to have to worry about excessive sweating and stained clothes...all with one simple relatively inexpensive treatment session...

Ken Landow, MD
Las Vegas Dermatologist
4.5 out of 5 stars 9 reviews

Botox for Underarm Sweating - Hyperhidrosis

The amount of Botox varies for those with small body surface area (90 pound teenager) versus a 240 pound body builder who has a large axillary surface. Anywhere from 50 - 100 units are used per axilla. I don't use Dysport as Botox has stood the test of time in my practice with over 1,000 patients treated with Botox for hyperhidrosis - and quite effectively - with the very rare patient who finds minimal relief.

Botox or Dysport for Hyperhidrosis

Typically we use 50 units Botox for each armpit, for a total of 100 units Botox.  For Dysport, this equates to a total of 300 units Dysport.

Sam Naficy, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 167 reviews

Botox or Dysport Units for Hyperhidrosis Treatment?

All of the studies of Botox and Dysport show that roughly 2.5 units of Dysport are required for the same effect as 1 unit of Botox. Thus, each armpit would require 50 units of Botox or 125 units of Dysport for full effect. I hope this is helpful.

Stephen Weber MD, FACS

Stephen Weber, MD, FACS
Denver Facial Plastic Surgeon
5.0 out of 5 stars 76 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.