Hyperhydosis of the facial "t-zone" has made my life very difficult. What can I do?

Above the lip, and the nose, with some around the brows. I've read botox is a treatment option, but two dermatologists said I should speak to a plastic surgeon. One PS's office said no, and the other said such a high amount of botox would be required that I risk paralyzing the muscles in the area and they don't think it's an advisable solution. I'm not interested in medication because I have severely dry eye issues and have heard it can worsen on the meds. I would greatly appreciate any advice!

Doctor Answers 6

Facial Hyperhidrosis -- Botox

this can be improved with botox or oral medications.  Please see an expert for an evaluation.  Best, Dr. Emer.

Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 190 reviews

Facial hyperhidrosis

Botox, which is often used to treat excessive sweating in the hands feet and underarms, can also be used safely for facial hyperhidrosis.  I've used it. as you suggest for the lip area under the nose as well as the forehead.  I often treat the face cosmetically and add small amounts to curtail the perspiration problem areas.  I disagree with the plastic surgeon who asserted that you need to use a high amount of Botox for this purpose.  I would go to a board certified dermatologist who treats patients with hyperhidrosis.  Many do not because it is often difficult to be reimbursed through insurance.  I hope this helps. Dr. Adrienne Stewart MD FAA D

Adrienne E. Stewart, MD
Denver Dermatologic Surgeon
5.0 out of 5 stars 6 reviews

T-zone hyperhidrosis

I am so sorry you are having a difficult time finding treatment for this problem. Botox can certainly be used around the brow and nose and typically even a small amount injected superficially can help tremendously. Botox around the mouth can be tricky because it can affect the muscles, but it does wear off in 3-4 months, so if you didn't like the result, it would not be permanent. Finally, Ultherapy can be used to injure the sweat glands on the lip and would have the nice side-effect of tightening the skin and decreasing the wrinkles (if you have them) . I hope this helps you!Dr. Quenby Erickson

Quenby Erickson, DO, FAAD, FACMS
Chicago Dermatologic Surgeon
5.0 out of 5 stars 30 reviews

Facial hyperhidrosis, no problem

I don't see this as a difficult problem. I can treat this a couple ways. I can treat with microBotox/Dysport with very low doses which won't affect the movement muscles. I do this frequently for acne and it will work similarly for hyperhidrosis. Also, the Infini can be used to injure the sweat glands. This is a more permanent solution but requires up to 3 treatments. Sweat glands when destroyed don't grow back.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.7 out of 5 stars 41 reviews

Botox for hyperhydrosis

Botox is used for treatment of hyperhidrosis in the axilla and palms with excellent results.  On the face I would recommend patterns and dosages that yield optimal cosmetic results.  Most of the time, the associated improvement in the hyperhidrosis is very satisfying. I would certainly give it a try.

Jeff Birchall, MD
Carlsbad Physician
4.7 out of 5 stars 5 reviews

Hyperhydrosis of the facial T zone

Thanks for your question.  Tough problem.  There is the new laser available for hyperhidrosis call the MiraDry but it is not approved for the face.  See the MiraDry website for information.  Your dermatologist may have other creams that can be compounded for the sweating such as glycopyrolate.   You may need to wait for the topical botox cream to become available.  Good luck

Paul E. Goco, MD
Nashville Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

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