How Many Units of Botox Are Needed to Prevent Sweaty Palms?

You can always tell whether there is a definitive answer in medicine when everyone answers the same way. And if you get lots of different answers, you know that the jury is still out. A couple of years ago, I reviewed your question for my own needs. The bottom line is that the best starting dose is 50 units per palm.
Dilution was not critical, but most studies use either a 4 cc dilution or a 5 cc dilution. Any dose less than that, and you may suffer from incomplete resolution or compromised duration. I also appy a topical anesthetic cream to the area for a half an hour prior, which makes it quite tolerable.
The largest body of literature supports the numbers mentioned above. And as Dr Lupo notes, some patients may still need a little more but it is rare. And in fact has not happened in my practice thus far.

Botox injections can be applied to the palms for hyperhidrosis. The amount needed depends on a careful mapping of your 'hyperhidrosis hotspots' and the severity of your problem. I usually inject between 50 and 150 units per hand. Best, Dr. Karamanoukian Los Angeles

Using botox for palmar hyperhidrosis is an effective way to decrease sweating. The botox prevents the nerves from telling the sweat glands to secrete sweat. Each palm will need 50 to 100 units depending on the size. The cost depends on the cost per unit in each office. Botox ranges from 10-15 dollars per unit in my area.

I would recommend anywhere from 50-100 units per palm.  I take the following in consideration:

1)  Small hand (lower starting dose)

2)  Budget constraints (lower starting dose)

Ultimately with any Botox treatment (cosmetic, hyperhidrosis, migraines, etc.) you want to customize the treatment and set expectations.  Larger doses typically last longer than smaller doses, but there is a upper max to the longevity with the most one can expect is 6 months.  If a lower starting dose results in a shorter duration of relief, then I would recommend increasing the dose with the next treatment.

50-100 units per palm is a typical dosage for hyperhidrosis of palms. It is better to start with the lowest dose you need to achieve satisfactory relief from excess sweating to minimize expense but also to prevent any subtle effect on fine motor movements, which would be relevant for a violin or piano player.

The range appears to be between 50 and 100 units per palm. Most physicians seem to start with 50 units per side and see what result you obtain before increasing the dose. Its effect may last longer than the cosmetic facial Botox treatments, but you shouldn't expect more than six months duration.

There are about 100 units per vial of Botox and 300 units per vial of  Dysport per and typically I would use 1 vial of Botox to treat both palms which would amount to about 50 units per palm whereas I would use about 200 total units of Dysport (100 per palm).

Hi,thank you for the question.The minimum number of units required for each palm is 100.And the dose can be adjusted depending on the maximum color change with starch iodine test.Consult a board certified dermatologist for the best dose requirement.

Although some physicians will start at 50u per palm of Botox, we typically start at 100u per palm which generally delivers an excellent and longer lasting response. Perhaps 10-15% of patients can use 150u per palm. Best to chat with your local dermatologist for proper diagnosis, workup and optimal treatment.

We have found that 300 Units Botox for palmar hyperhidrosis is what is required to control this condition for 6-9 months.   I hope this is helpful.Steve Greene MD,  Advanced Dermatology and Laser Institute of Seattle