Botox Side Effects Injecting Hands, Sweaty Palms?

What are the side effects possible from getting botox for sweaty palms / hands?

Doctor Answers (13)

Botox for sweaty palms works very well

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Using Botox for sweaty palms works very well.  Side effects are usually minimal, and consists mostly of soreness and bruising at most.  Although none of my patients have experienced this, you can possibly have some minor weakness of the hand.  In the past, I did nerve blocks which was unpredicatable and painful.  Now, with using an ice technique, it goes very smoothly and quite comfortably.  You can expect between 3 and 6 months improvement, and the more times it is done, the longer the results.  I use 50 units per hand.

Panama City Facial Plastic Surgeon
4.5 out of 5 stars 9 reviews

Botox into palms for sweating: risk of some hand weakness.

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Botox injected into the palms and fingers for excessive hand sweating can work wonders. Negative aspects to consider include the potential extreme discomfort of the treatment (an experienced doctor will use ice or numbing cream to help) and the real possibility of hand weakness if some of the Botox goes deeper than the intended sweat gland muscles, into the functional muscles of the hand.

Jessica J. Krant, MD, MPH
New York Dermatologic Surgeon
4.5 out of 5 stars 40 reviews

Botox terrific for palm sweating

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Both Botox and Dysport are highly effective and safe treatment for excessive sweating of the palms(hyperhidrosis). Botox has been FDA approved since 2004 for treatment of hyperhidrosis and is widely use for this indication. During your treatment, a topical numbing anesthetic may be applied. Then small injections of Botox is placed directly under the skin of the palms, usually about 20 injections are made to each area. The process takes about 10-15 minutes with minimal discomfort.  Side effects are minor, some patients may have soreness and bruising.  Since the sweat glands and our hand muscles are in close proximity, it is possible you may have some minor muscle weakness.  I would recommend going to an experienced injector who can minimize these side effects.

Most patients will notice an improvement in about 2-4 weeks. While results may vary, patients will notice at least 6-7 months of improvement.  For my patients with severe hyperhidrosis that has impacted their lives significantly, this treatment is a life changer! My patients no longer have to worry about being embarrassed about shaking other people's hands, and they don't mind going out to meet new people.

Good luck!
-Dr. Margaret Mann at The Dermatology Center at UC Irvine

Margaret Mann, MD
Cleveland Dermatologic Surgeon
5.0 out of 5 stars 1 review

Weakness is the main side effect

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When the palms are injected with BOTOX or DYSPORT for excessive sweating, the main side effect is hand weakness or pinch weakness.  Feeling to the fingertips remains the same, but some of the small muscles needed for pinch or fine movements may be weakened.  There are no muscles in the fingertips so neruromodulators such as BOTOX or DYSPORT injected into the fingers does not cause any weakness.  The injections are superficial, but some can travel into the deeper muscles and cause weakness.  Any weakness would be temporary.  Sweat improvement may last 6-12 months.

The web reference is a medical article that dicusses a graduated treatment including topical aluminum chloride in addition to BOTOX.

Keith Denkler, MD
Marin Plastic Surgeon
5.0 out of 5 stars 2 reviews

Botox for sweaty palms

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Botulinum toxin has been used for people who have hyperhidrosis of palms and soles and underarms. Injections of the palms can be painful and doctors who become experienced at this treatment develop techniques in making the injections less uncomfortable, such as numbing cream, cold air, ice immediatley prior to the injection and anesthetic blocks.  There can be some weakness noted with grip strength especially with the thumb so depending on your occupation or need of hand clenching, certain areas might purposely be avoided or have less units injected.  You should definitely see a physician who is expert in this treatment.

Ronald Shelton, MD
Manhattan Dermatologist
5.0 out of 5 stars 33 reviews

Botox for sweaty palms

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Botox for sweaty palms, hyperhidrosis, is an excellent treatment to manage this condition. The palms of hands and fingers are extremely sensitive and these injections can be slightly painful without the proper anesthesia. Using cold air or blocking the nerve at the wrist with anesthesia can help. You may experience mild muscle weakness in your hand but this should resolve within 1-2 weeks. See an experienced Botox injector for this issue.

Etai Funk, MD
Houston Facial Plastic Surgeon
4.5 out of 5 stars 15 reviews

Yes but could have side effects.

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If you know you respond well to BOTOX®, then there’s really very few risks for using injections to treat sweaty palms. Some people may notice pain at the injection site, but this can be alleviated with a topical numbing cream or by taking an over-the-counter pain reliever like ibuprofen before your appointment. The main side effect mentioned here, concerns over weakness in the major muscle groups of the hands, shouldn’t be an issue as long as you go to an experienced injector who is familiar with using BOTOX® for hyperhidrosis treatment. As long as you take your time to look around and find a practice you’re comfortable with, you should see great results using BOTOX® for your excessive sweating.

Only good significant side effects are likely...

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overwhelmingly there are no side effects but remember botox is principally used to relax facial muscles...and sometimes when the palms are treated, the botox may temporarily lessen muscle strength in the hands...if it occurs, it tends to interfere with fine buttoning a shirt...but it is fleeting and recovery usually occurs in a week or so...nothing like treating the facial muscles where the effects last 3-4 months...aside from this, the procedure is a piece of cake...and with current numbing there's nothing of significance to worry about...hands should be dry for 6-12 worry free months

Ken Landow, MD
Las Vegas Dermatologist
5.0 out of 5 stars 8 reviews

Botox complications in the hand for hyperhidrosis is RARE !

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I have injected Botox in the hands over 800 times over a course of 10 years or more. I have taken care of hyperhidrosis patients for over 13 years. Very rarely, patients get weakness of a finger but it seems to go away very quickly - within 2 weeks. Because hand muscles are used very frequently, the effect of Botox in causing muscle paresis (weakness) dissipates quickly. Again, a practitioner with a lot of experience is needed to inject Botox for palmar hyperhidrosis because depth of injection is critical - it is done quickly with 5-8 injections for each syringe until ice is applied in between syringe refills and therefore experience in putting the needle in a proper depth is critical. There is not much time wasted because icing in between syringe refills keeps the skin cold and rovides proper anesthetic. There is no need for anesthetic blocks.

Botulinum Toxin injections for Sweaty Palms - Side Effects

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Thanks for the question! Botulinum toxin injections are very effective in treating sweaty palms (palmar hyperhidrosis) and side effects are rare. While it is possible to develop mild weakness of the hand muscles this is rare, because the botulinum toxin is administered to the sweat glands in the skin, not into the muscle. The likelihood of weakness is highest when the injections are administered by an inexperienced individual who injects the botulinum toxin too deeply.

Because hands and fingers are very sensitive, administering the botulinum toxin can be quite painful if done without anaesthetic. The procedure is very comfortable when performed with anaesthetic nerve blocks, which can be done quickly and effectively with two injections at each wrist. After these blocks take effect there is no pain, which further reduces the chances that the botulinum toxin will be injected too deeply in the hand and cause weakness.

Bruising can be minimised by using ice at the time of the procedure.

The risk of infection from an injection is low. Your hands should be cleaned prior to the injections and I recommend avoiding situations that could increase your risk of infection (such as cleaning out a fish aquarium or digging in the garden without gloves) for 24 hours after the procedure.

Jill Tomlinson, MBBS, FRACS
Melbourne Plastic Surgeon

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.