Does exercise/lifting weights reduce effectiveness or longevity on Botox for underarm hyperhidrosis?

I have many patients in which the botox or other neurotoxin doesn't last as long in suppressing wrinkles on the face -- especially those patients who exercise a lot or are very expressive.  I have a few patients who have reported a similar effect in underarm, palm/sole, or back sweating.  These patients typically require higher doses to maintain another patients similar clinical effect.  It appears to me that when there is more neurological activity, the toxin is challenged and new or alternate connections are made to compensate.  This is not something that anyone should be concerned about, and is not something I hear often, but i thought it would be best to report.  I wish you the best of luck, Dr. Emer.

This is a good question.
There is potential that an increase in sweat may cause the Botox to wear off
faster, however, I do not believe that there would be a very significant change
in the length of time it would last. It is important for your overall health to
continue to exercise regularly, so I would not worry too much about this.

Botox and, now, Dysport for underarm hyperhidrosis are great options for reducing sweating.  If you are experiencing issues, consider this as the treatments last for up to 3-6 months and are a terrific choice.  I haven't ever heard of them being shorter due to exercise, which is a good thing!

Your physical activity should not affect Botox regardless of whether it is used to soften lines and wrinkles or reduce underarm perspiration. Feel free to hit the gym the day following your treatment! I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Exercise and weight lifting does not reduce the effectiveness or duration of Botox treatment for underarm sweating. Of course, any strenuous activity should be avoided for the first 24 hours after your injections.

You know, thats a great question. I actually just spent 30 minutes research the medical literature on this. I dont really see anything suggesting that this is the case. From a physiology point of view, i would doubt that exercise would decrease the effectiveness. I think you are safe to exercise without worrying too much about it. 

Interesting question. We've noticed that for our cosmetic patients, Botox and fillers don't last as long when they overuse their facial muscles (e.g. grimacing with weight lifting). We have not heard the same nor are their scientific reports of this for hyperhidrosis, although it is conceivable.

Botox is an excellent way to treat underarm hyperhidrosis.  Exercise/lifting weights does not reduce the effectiveness or longevity of Botox.  Some patients need more Botox to maintain this area in a similar way that some patients need more units injected into the face.  For the best results please find a board certified dermatologist with a great deal of experience with Botox.

Because Botox in the underarms is used to stop some of the glands from actually producing the sweat itself, it is not affected by exercise. It's affected by time and metabolism only. "This answer has been solicited without seeing this patient and
cannot be held as true medical advice, but only opinion. Seek in-person
treatment with a trained medical professional for appropriate care."