How Much Botox is Safe to Use in One Appointment?

I have finally saved up enough money for treatment of my hyperhidosis. I will be getting treatment for my underarms. I am also considering getting my forehead done at the same time. My question is getting this large amount, is it safe? Thank you for your time.

Doctor Answers 11

Botox safety

You should have no safety concerns about this. Usually, 50 units is placed into each axilla (arm-pit) and 6-15 units in the forehead. This is well below the 2500-3000 units, which is said to be a toxic dose.

I am curious, however, that you are saving up money for the procedure. Most insurance companies do cover BOTOX. They would like another treatment modality be attempted first for the control of hyperhidrosis.

Usually, this means a trial with medical grade aluminum chloride or an anti-cholinergic medication. Then they give approval and pay for the Botox and its administration. You would have to pay for the forehead treatment unless you have hyperhidrosis in this area.

Good luck and I hope I save you some money.

Virginia Beach Dermatologist
4.7 out of 5 stars 14 reviews

Botox dose = upper limit, toxic dose

Typical Botox injected is 2 or 3 bottles if large areas are treated for hyperhidrosis. To give you an idea, it means 200 - 300 units. The toxic dose would be 30 bottles. No one in their right mind would inject that amount and it is unnecessary, impractical, and very costly.

Hratch Karamanoukian, MD, FACS
Buffalo General Surgeon
4.9 out of 5 stars 38 reviews

Botox quantity for injection often not toxic

The quantity of Botox for hyperhidrosis is highly variable and dependent on the type and severity of the hyperhidrosis, the area of the treatment region, and the past experience with Botox.

The quantity necessary for Botox injection are not enough to cause complications or toxicity to a patient. However, the injection amount should be titrated to the area in order to minimize the cost and the overall amount of Botox used.

In some patients, requiring increased amounts of Botox compared to norms, Myobloc may be an alternative.

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 94 reviews

One Botox session for underarms and forehead is safe

For the average sized person, the toxic dose of Botox is 2500-3000 units. The typical dose of Botox for the underarms is 50 units per side, and that of the forehead is about 15 units. So to answer your question, yes, I believe it is safe.

Bryan K. Chen, MD
San Diego Dermatologist
5.0 out of 5 stars 5 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. 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.

Young R. Cho, MD, PhD
Houston Plastic Surgeon
4.8 out of 5 stars 34 reviews

Botox is safe

The typical dosage for treating underarm hyperhidrosis is 100 units per side.  The average number of units to treat the forehead is 10.  You can very safely use this amount of Botox in one appointment. 

Martie Gidon, MD, FRCPC
Toronto Dermatologist
5.0 out of 5 stars 22 reviews

Botox to each armpit

I usually place about 50 units in each armpit. This is well under the toxic dose at any one time.  I would't worry too much.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 26 reviews

Are high doses of Botox safe?

As the other panel members stated, your concerns (although appropriate) should be relieved in knowing that it would take much more Botox than what you are contemplating to cause concern.  Botox is routinely administered in much higher doses for medicinal purposes.

Being that you are making a large financial investment in treating hyperhidrosis (sweaty underarms) with Botox, you may want to have the forehead treated first if you need reassurance about your reaction to Botox.  Other than needing peace of mind and reassurance, your combined treatment is not unusual and is considered safe.

See the link below for further information on the use of Botox for hyperhidrosis.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.3 out of 5 stars 6 reviews

200 units is safe

Typical cosmetic uses of Botox Cosmetic uses 50 to 100 units. However, it is safe to use more Botox per session. You will be fine if you receive 200 units of Botox. We often use even more Botox for non-cosmetic (medical) conditions without any problems. Good luck with your injections.

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 74 reviews

Botox safe and effective for hyperhidrosis and wrinkles

Botox Cosmetic is safe and effective for hyperhidrosis and the wrinkles you describe. The treatment is local, meaning that the small amount of volume injected should not go throughout the body. Problems arise if too much is used and gets into the blood stream. It can cause paralysis, particularly of the breathing muscles.

A skilled doctor can evaluate you thoroughly and help you. It sounds like you should be able to get all areas treated however.

Scott E. Kasden, MD, FACS
Dallas Plastic Surgeon
4.7 out of 5 stars 98 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.