Botox for Hyperhidrosis - Worked Just for 2 Weeks. Normal?

There are no cookie cutter answers. I have coauthored a book on hyperhidrosis and have seen patients with resistance to Botox. I would suggest an alternate neurotoxin. Best, Dr. Karamanoukian Los Angeles

Thank you for your question. Botox is a very effective treatment for hyperhidrosis (armpit, hands, feet, scalp/face, etc). The dosing is typically based on areas treated but can vary around 50 - 100 units per side depending on how large the treatment area. Duration also depends on dose and technique, but can vary from 3-6 months. It would helpful to know what dosage was used and actually observe the technique.  I often find that injecting at the wrong depth can cause most of the botox  to go deeper than the sweat glands. For the armpit region, you may also want to consider miraDry as it provides a longer lasting relief and in the long run is more cost-effective.

Our office specializes in Miraday. Miradry just got FDA clearance for elimination of all hair colors under the arm. It also has clearance for the elimination of underarm sweating and odor.  Much cheaper than botox and permanent.

Its best to follow-up with your provider, he/she would know how many units were applied and the dilution. You may have been under dosed and would require more units

Typically results last between 3-6 months for hyperhidrosis and in some cases longer.  You should speak with your injector to see how many units were used and what dilution.  

Botox is generally a great option for patients living with hyperhidrosis. Without knowing the amount of Botox that was injected, it is hard to say exactly why your results did not last. The number of units injected and placement of the injection may be the cause of your short-term results. I would suggest you seek treatment from an expert Botox injector to ensure optimal results.

While BoTox has excellent results for hyperhidrosis of the axillae (armpits), it is only a temporary measure.  Depending on how much was used along with the location of the injections, results typically last for 6-12 months on average.  Without knowing this information, I am unsure of why yours would have lasted for only a couple of weeks.  

One option to also consider would be liposuction to the areas, or even subdermal shaving to excise the sweat glands permanently from the axillae.  This has had dramatic and excellent results with minimal complications and small incisions.  Good luck!

Botox for hyperhidrosis is usually very effective and long lasting.  Some excessive forms of hyperhidrosis in large areas may require adjunctive treatments with other medications.  It is difficult to comment on your treatment without specifics including how severe, whether testing was performed, the area treated and the dose used.  All these factors have an impact. On average for the axillas, 50 units lasts 6-9 months, 100 units 9-12 months and 200 units 12-20 units.

Two weeks would be an unusually short duration for Botox treatment. Even though Botox can last six months to a year or longer, it does not cure the condition. 
We use SmartlipoTriplex laser treatment to permanently ablate the underarm sweat glands. This is a short office procedure done with local anesthetic. Starch iodine is used to demarcate the area of sweat glands, and the laser is used to ablate the sweat glands.

This procedure may cost about 3,000, but has a good chance of markedly decreasing or eliminating excess sweating long term.

It is hard to determine why this did not work so well for you.  It could be dilution, administration, or not enough medicine. There have been instances where the protein broke down and it was ineffective.  Please talk with your well trained and experienced injector.  Hopefully they will come up with a plan to treat the situation.