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Are Botox Injections for Hyperhidrosis Painful?

asked 2 years ago by SeattleMike in Seattle, WA
Latest answer by Jill Tomlinson, MBBS, FRACS
Question viewed 1,268 times
Tags: pain

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

15 answers to Are Botox Injections for Hyperhidrosis Painful?

+1

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... more
Jill Tomlinson, MBBS, FRACS

Melbourne Plastic Surgeon
+1

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... more
Glynn Bolitho, PhD, MD, FACS

San Diego Plastic Surgeon
+1

Injection of Botox for hyperhidrosis generally not painful

All and all injection of Botox for hyperhidrosis is well tolerated. However for some patients this procedure is painful and in those cases we use topical numbing cream, ice and vibration to make this a tolerable procedure
Nissan Pilest, MD

Irvine Dermatologic Surgeon
+1

BOTOX injections for Hyperhidrosis

In general, patients that I treated for hyperhidrosis in the armpits and the palms of the hands have not complained of significant pain. I admit that I am surprised that they do not complain but they seem to want the treatment so badly and they appreciate the results so much that they are able to withstand any discomfort. Unlike forehead injections of BOTOX for cosmetic purposes, the injections in the armpits and on the palms of the hands are very superficial. Icing the areas beforehand may... more
Sigmund L. Sattenspiel, MD

Freehold Facial Plastic Surgeon
+1

Botox injections are painless with an anesthetic

I mix some local anesthetic in with the Botox (it has to be "buffered" lidocaine to neutralize the pH). Injections over large areas such as the underarms are virtually painless with this technique.
Robert C. Langdon, MD

Guilford Dermatologic Surgeon
+1

Botox for hyperhydrosis

Discomfort from injections for hyperhydrosis can be controlled with topical ice, and/or topical numbing creams. It's an office procedure which has a very high success rate.
Darrick E. Antell, MD

Manhattan Plastic Surgeon
+1

Pain of botulinum toxin injections (Dysport, etc) for axillary hyperhidrosis (armpit sweating)

Clearly this varies tremendously among patients and physicians. As alluded to by the other physicians comments, many patients tolerate this well without the topical anesthetics. Others desire cream and some even request anti-anxiety medications. We treat each patient individually according to their unique situation and preferences.
Otto Joseph Placik, MD

Chicago Plastic Surgeon
+1

Botox injections in axillary areas for hyperhidrosis rarely require anesthesia

I have found that most patients rarely require any kind of anesthesia for Botox treatments in the axillary areas. The procedure is a very quick and can be done in less than 2-3 minutes. Treatments in the palms and soles is more painful and usually requires topical anesthesia and some patients require nerve blocks. I hope you find this helpful.
Steven E. Rasmussen, MD

Austin Dermatologist
+1

Botox Injections for Hyperhydrosis, Painful....No Sweat, Soon There Will Be Topical Botox

Hi Seattle Mike, Most patients do not require any numbing or anesthesia before injecting Botox into the axilla (arm pits) for excessive sweating. We give patients a swig of Whiskey and a silver bullet to bite on...just kidding. Actually very good news is on the way. At the recent IMCAS in Paris,Dr. Michael Kane, a plastic surgeon from NY, presented the phase 2b data from Revance's RT001 (not related to R2D2) - also known as "topical botox." This topical preparation allows the botul more
Michael A. Persky, MD

Los Angeles Facial Plastic Surgeon
+1

Hyperhydrosis injection with Botox

Treating over production of sweat or treating hyperhydrosis can be accomplished with Botox. It can be done with little to no pain especially if a topical anesthetic is used.
Steven Wallach, MD

Manhattan Plastic Surgeon
+1

Botox injections are usually not that painful for hyperhidrosis

Most patients tolerate the Botox injections for hyperhidrosis quite well with just a topical anesthetic and a chiller blowing ice cold air at the time of the injections.  Cost is about $1500-2000 and lasts about 6 months.  
David Hansen, MD

Beverly Hills Dermatologic Surgeon
+1

BOTOX Injections for excessive underarm sweating are not painful.

You would think that underarm injections are painful, but the majority of my patients elect not to have topical anesthetic. There is certainly no harm in having topical anesthetic applied around 20 mins. before your procedure. You can discuss this with your physician. Results last 4 to 6 months, and patient satisfaction is very high. I hope this is helpful for you.
Eric M. Joseph, MD

West Orange Facial Plastic Surgeon
+1

Botox for sweaty palms requires numbing

I would echo the previous comments and agree that Botox used to treat Hyperhidrosis of the axilla is very well tolerated without numbing however the hand requires more than just topical or ice as it tends to have a denser array of pain fibers.
Charles Perry, MD

Sacramento Plastic Surgeon
+1

Botox injections for severe Sweating (Hyperhydrosis)

Botox injections to the arm pits are very well tolerated with mild icing. Botox injections to the palms are a different matter and nerve blocks are commonly needed; the blocks involve a few small injections with a small needle leading to numbness of the palms. Dr. P. Aldea
Peter A. Aldea, MD

Memphis Plastic Surgeon
+1

Topical anesthetics are great for hiperhidrosis

The axillary or armpit area readily numbs up well with topical anesthetic and it really helps. Localized shots for numbing are not usually necessary. Hyperhidrosis of the hands requires numbings shots in the wrist to put the hand asleep. Otherwise the large number of shots and a sensitive area can be a lot for patients to bear even with a topical anesthetic.
Keith Denkler, MD

Marin Plastic Surgeon

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