Why is Botox Needed Every 6 Month for Hyperhidrosis?

does Botox disappear after 6 month what happens to the amount that they first inject? Im 23 years old if i inject Botox every six month for the rest of my life where is all the Botox store? does it disappear? My doctor says the sweat has to come out some how and if i stop the sweet from my hands, feet and armpit will I be sweeting in other areas of my body like my back etc??.. he recommended a different technique call Iontopheresis, have you try this technology with your patients?

Doctor Answers (13)

You should consider cellulaze or smartlipo for axillary hyperhidrosis.

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Botox typical lasts 6 months. it works very well but it is expensive and has to be repeated. 

i have used the cellulaze system, off label, for hyperhydrosis of the axillary region with good results. 
it appears to last many years and may be permanent, so it is much more cost effective. you should be able to
return to the work the next day. you will be in and out of the procedure in about 30-45 minutes. 

david berman md
plastic surgeon
northern va


Sterling Plastic Surgeon
5.0 out of 5 stars 24 reviews

Why is Botox Needed Every 6 Month for Hyperhidrosis?

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Botox is not a permanent treatment and usually lasts 3-6 months to help control Hyperhidrosis, once your body metabolizes the product, you’ll start to notice the effects wear off 

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

Botox Duration

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Botox for hyperhidrosis typically lasts between 3-6 months with most patients lasting closer to 6 months than 3 months.  Its effects end when the botox no longer binds to the sweat gland and normal function of gland resumes.

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
5.0 out of 5 stars 76 reviews

Repeated Botox injections for hyperhidrosis

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Botox injections for hyperhidrosis typically last 4-6 months.  Like most medications, Botox is not stored long term in the body.  It binds to receptors then is metabolized and breaks down.  Usually with repeated treatments the frequency of Botox injections can be decreased.  When it is for hyperhidrosis, insurance usually covers the costs.

Dina D. Strachan, MD
New York Dermatologist
3.5 out of 5 stars 9 reviews

Botox injections and need for repeat injections

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The current Botox 'neurotoxin' wears off and needs to be replenished to garner the desired effect. Rest assured that another company is working on a variant that has a longer lasting effect - I am sure they are investing hundreds of millions of dollars to fgure it out - it would be like taking a medication for high blood pressure (like Toprol) 3 times a day and then developing an extended release medication that is taken once a day (Toprol XL). It is the same issue with Botox and another version that lasts longer. However, the down side of that is that if it lasts longer and you don't like the effect, you are stuck with it ... Having said that, Botox has helped millions of people with over 22 FDA indications and growing yearly and you can keep getting it without known undue side effects or complications that we are aware of to date.

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

Botox can suppress sweating in the underarms for about six months

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It is often recognized that the botox effect of less sweating in the underarms or palms / soles can last longer than the relaxation effect of facial muscles for wrinkles.  Botox is not stored year after year if you continue to have the treatment. The molecule is metabolized and the effect wears off.

Ronald Shelton, MD
Manhattan Dermatologist
5.0 out of 5 stars 31 reviews

Treatment options available for Hyperhidrosis

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Botox injections are helpful for axillary hyperhidrosis, but only last about 4-6 months in my experience. I have also treated the palms and soles, which is a bit more painful and doesn't last as long, most likely because it is a larger treatment area (50 units per hand/axilla/sole).  Some insurance companies will cover the cost of this, so you might want to look into it, however, if you are treating 3 sites (axilla, palms and soles) that would be quite expensive. There are other treatments to consider: Drysol, Drionic device, and oral medications (Pro-Banthine, glycopyrrolate, diltiazem, clonidine) may be helpful. Drionic is also known as Iontophoresis and is a simple device which uses tap water soaked pads to pass a low level electric current through the tissues, shutting off the sweat glands. The cost is $198.00 for the underarm pair of pads. You can go to their web site for more information (below). I do use it and for many patients it works well. I note that you also have palmar and plantar hyperhidrosis and they have pads for these areas also. It is a single unit for hand/foot treatment and it is less than the cost for the axillary pads ($180.00).

MiraDry is the newest treatment for axillary hyperhidrosis using microwave energy and it should be permanent. There is also literature out on using Ulthera (Ultherapy) for treating axillary hyperhidrosis. Ulthera uses focused ultrasound and can target deeper tissues than MiraDry. The treatment should be permanent since the sweat glands are destroyed. The Ulthera protocol that has been reported I believe is 100 lines dual plane for each axilla (200 lines first visit) and this is repeated a month later (400 lines total). The cost should be around $3,000.00 similar to MiraDry ($3,000.00 - $4,000.00).

Surgery involves upper thoracic sympathectomy, and this should not be taken lightly. I have had patients that have had this done and while it does improve axillary hyperhidrosis some patients shift the sweating to other areas, such as the abdomen or flanks.

Your dermatologist can review all of these treatment options, many of which are covered by insurance. I hope this helps you! Good luck!

Curt Samlaska, MD
Las Vegas Dermatologist
5.0 out of 5 stars 2 reviews

Botox for hyperhidrosis

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  The general idea is that after a certain number of treatments, the Botox will work for longer periods of time.  It would be wonderful if your insurance would cover the treatment although I have not been very successful for getting insurance coverage for Botox for treating this particular problem.

Lawrence Kass, MD
Saint Petersburg Oculoplastic Surgeon
4.5 out of 5 stars 47 reviews

Botox frequency and duration for hyperhidrosis (excessive sweating)

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Botox has been used safely and successfully for a number of years now in millions of people with hyperhidrosis, along with many other uses (e.g. cerebral palsy, club foot, urinary incontinence, migraines, cosmetic, etc). I find that in hyperhidrosis it lasts anywhere from 6-12 months depending on amount injected and injection technique. Hyperhidrosis is excessive and inappropriate sweating, the armpits for instance representing 2% total body surface area, so reduced sweating in this area does not exacerbate sweating in other areas. The Botox is broken down after 6-12 months, and does not stay in the body nor does it cause any harm.

Benjamin Barankin, MD
Toronto Dermatologic Surgeon
5.0 out of 5 stars 23 reviews

Botox and other methods for hyperhidrosis

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Botox is not stored in the body--it acts on the receptors in the skin and then the effects gradually wear off.  It is a very easy and relatively painless procedure to perform in the armpits.  It's also covered by most insurance plans and the doctor can help you with the necessary steps to get this covered.  However, if you have a high deductible, you may end up paying for most of it anyway so you may want to talk to the doctor to find out if there is a discount for paying cash.  The longevity of Botox is dose dependent--if a higher concentration or amount (number of units) is injected then it will last longer.  It can last 9-12 months depending on how much is injected.  Iontophoresis takes a lot of commitment and is difficult to maintain.  Botox is much more painful for hyperhidrosis of the hands so that's one area you might want to consider iontophoresis.  But since the armpits are basically painless with Botox and so easy to do, Botox would seem the better course for the armpits.  MiraDry is a new microwave device that actually permanently destroys the sweat glands after 2-3 treatments--it can only be used on the armpits.  Cellulaze is a new laser device by Cynosure used for cellulite but can also destroy the sweat glands underneath the armpits helping to control hyperhidrosis.

M. Christine Lee, MD
Walnut Creek Dermatologic Surgeon
4.0 out of 5 stars 14 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.