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 (16)

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

Brisbane Dermatologist
5.0 out of 5 stars 1 review

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

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 237 reviews

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 76 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.  

Young R. Cho, MD, PhD
Houston Plastic Surgeon
5.0 out of 5 stars 10 reviews

Fortunately an Easy Answer...


almost by convention 50 units of botox under each arm is the way to 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
5.0 out of 5 stars 7 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.

Hratch Karamanoukian, MD, FACS
Buffalo General Surgeon
4.5 out of 5 stars 7 reviews

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 147 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 43 reviews

Botox injections and retrograde suction curettage for axillary underarm sweating


Botox injections are effective temporarily for underarm sweating, whereas a more definitive treatment in my practice would be Retrograde Suction Curettage of the axilla.  I would also recommend Miradry procedures, which are effective with one or two therapies. 

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 53 reviews

Botox Units for Hyperhidrosis


Good question.  In general, 50 units of Botox per side for a total of 100 units Botox is necessary for an effective dose.  For Dysport, 150 units per side or a total dose of 300 units is necessary.  100 units of Botox costs about the same as 300 units of Dysport, so there really is no cost difference.  You should see an effect in 3 to 7 days and the effect should last 4 to 6 months.


Good Luck.

David Shafer, MD
New York Plastic Surgeon
5.0 out of 5 stars 57 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.