Are Botox Injections for Hyperhidrosis Painful?

Or, do you "pre-numb" the areas being treated with some type of topical agent so it is less uncomfortable for the patient?

Doctor Answers 23

BOTOX injections for hyperhidrosis are usually well tolerated.

We use a numbing cream for the underarm region, but for the palms and soles, ice+ vibration is usually adequate. In anxious patients, I use a regional block.

Are Botox Injections for Hyperhidrosis Painful?

My office provides numbing cream before treatment to ensure as little pain as possible, mowt patients feel little too nothing when treating for hperhidrosis  

Botox for Sweating Pain Level

Generally speaking, botox injections are well tolerated.  We use a combination of a topical numbing + ice + a Zimmer cryo freeze to help make the injections as comfortable as possible.

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
5.0 out of 5 stars 93 reviews

Pain control with botox for sweating

Botox under the armpits for sweating is relatively well tolerated. You can place numbing cream beforehand and supplement this with a cold pack prior to applying it. You can also consider some form of distraction like vibration or tapping in the vicinity of the armpits as this will help confuse the brain with additional stimulation. Good luck

Numbing the palms for Botox hyperhidrosis

In our office in Los Angeles, we use topical numbing cream and apply a Zimmer cryo freeze to the skin prior to Botox injections for excessive sweating and hyperhidrosis. 

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 61 reviews

Hyperhidrosis botox, painful

Application of a topical anesthetic and ice help to diminish the pain from the small needle pinches required to inject Botox or Dysport.

Luis A. Cenedese, MD, FACS
New York Plastic Surgeon
4.5 out of 5 stars 12 reviews

Botox for Hyperhidrosis is not painful

Botix in the underarms is very tolerable when injected by an experienced practitioner. It is more painful in the hands and feet.

Are Botox Injections for Hyperhidrosis Painful?

Surprisingly, the superficial Botox injections for sweating are not that uncomfortable. I use a topical numbing cream and this significantly reduces the discomfort. The injections only take about one minute per armpit and most patients do not describe this as a bad experience. If it was painful, they wouldn't keep coming back! I hope this is helpful.

Stephen Weber MD, FACS

Stephen Weber, MD, FACS
Denver Facial Plastic Surgeon
5.0 out of 5 stars 72 reviews

Botulinum Toxin Injections for Hyperhidrosis

The degree of discomfort or pain varies depending on the body part.

For the arm pits most patients find that either ice or topical EMLA (a local anaesthetic cream) is all that is required to have a comfortable procedure.

For injections to the hands or feet I recommend local anaesthetic nerve blocks prior to treatment because the skin in these areas is much more sensitive. The nerve blocks provide safe, reliable and complete pain relief when performed by an experienced practitioner who understands the anatomy of the area being treated.

Jill Tomlinson, MBBS, FRACS
Melbourne Plastic Surgeon

Botox for hyperhidrosis

Botox treatments for hyperhidrosis of the armpits are very well tolerated with topical local anesthesia (EMLA).  Most patients seem pleasantly surprised at how little this hurts.  The same cannot be said for hyperhidrosis of the palms.  The skin of the palm and fingers is dense and and very painful to inject without preliminary local anesthesia.  I will typically block the two main nerves to the hand with local anesthetic, which then renders the entire palm numb.  At that point the Botox injections are completely painless.  Bear in mind that a permanent solution to hyperhidrosis can be achieved by means of a surgical procedure (sympathectomy).

Glynn Bolitho, PhD, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 10 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.