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

I had botox injected 3 weeks ago and at first it looked very promising. 2-3 days after injection sweating was minimal but it did not last long. Increased perspiration was clearly visible after 2 weeks and after 3 weeks sweating is so excessive as if i did not have any botox. I was full of hope and now I am devastated. Why it did not work? Should I do it once again? Thank you in advance for your advice. Maggie

Doctor Answers 22

Botox for hyperhidrosis is normally very effective

Botox for excessive underarm sweating is normally very effective. Most of my patients have a success rate of over a year of effectiveness, and some even 18 months. I am unsure how many units were injected, what the dilution ratio was, and where the injections were placed. All of this largely determines the effectiveness of Botox for underarm sweating. I would suggest at minimum, you see your injector for an evaluation and discussion.

Botox for excessive sweating

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

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 74 reviews

Botox for hyperhydrosis

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.

Try miradry instead

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.

Sheila S. Nazarian, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 39 reviews

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

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

Usually lasts 4-7 months.

i have had very good results using botox. it is unusual for it to last such as short period of time. ask your dr about the number of units injected per side.

i would suggest you see a plastic surgeon who is using the cellulaze laser by cynosure for treating axillary hyperhidrosis. it is a 30 minute procedure that only requires one very tiny incision per armpit and you can return to work the next day. results can last for years and may be permanent (as far as i know there are no follow ups beyond 3 years yet). this will be more expensive than botox but will not need to be redone, possible ever.

david berman md

plastic surgeon, northern va

David E. Berman, MD
Sterling Plastic Surgeon
5.0 out of 5 stars 47 reviews

Botox For Hyperhidrosis

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.  

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
5.0 out of 5 stars 109 reviews

Botox for Excessive Sweating

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.

Mitchel P. Goldman, MD
San Diego Dermatologic Surgeon
4.5 out of 5 stars 8 reviews

Botox for hyperhidrosis-underarms

Hi Maggie! While I haven't had this experience with my patients, I have heard of this happening. It is likely that your Dr was conservative in the units of Botox used and more may be necessary. Dilution of Botox is also an important component. When done to full correction, it is a great option for this problem. I wish you best of luck in resolving your problem! - Dr. Boris

George T. Boris, MD, FRCS, FACS
Los Angeles Facial Plastic Surgeon
4.0 out of 5 stars 14 reviews

Botox for hyperhidrosis is temporary, MiraDry is long lasting

Although Botox can work well for hyperhydrosis, it is temporary and expensive.  After years of using it for patients with varying results, I've switched everyone to MiraDry.  The costs are similar for something long lasting.

The miraDry procedure is an FDA cleared non-invasive method to eliminate the sweat glands in your underarms.  It uses microwave energy to destroy the sweat glands, eliminating the excessive sweating problems of people with axillary hyperhidrosis.  After application of a local anesthesia for comfort, the miraDry hand piece is placed where the sweat glands reside and applies the energy that eliminates them.  The treatment will take about an hour.

What are the expectations with miraDry?
An immediate reduction in sweat will be noticed after the procedure is complete.  Some localized soreness or swelling will occur and is normal, treated with a mild over-the counter pain reliever and ice packs.  Downtime is minimal to none at all.  We do recommend that you not exercise for a few days after treatment.

The eliminated sweat glands do not grow back or regenerate.  A recent clinical study indicated an 86% reduction in underarm sweating.  The procedure requires 2 treatments, 3 months apart for maximum results.    
This is one procedure I can say with confidence to my patients absolutely works well!


 

Lee P. Laris, DO
Phoenix Dermatologist
5.0 out of 5 stars 15 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.