Botox Injections on the Scalp to Treat Hyperhidrosis?

Question

I sweat profusely from my head. It is so bad that people assume I wear hair gels. I am almost always wet. Oddly, I have average perspiration from my armpits. I don't see why you couldn't inject Botox into the scalp (I can't wiggle my ears anyway.) I simply can't find anything on the Internet that references the practice. If it could be done, how many units would be required?

Sheila S. Nazarian, MD · Answer

Injecting botox to the scalp is not an uncommon practice.  You just need a lot of botox and sometimes price is an issue.

Young R. Cho, MD, PhD · Answer

Botox is an effective treatment for scalp perspiration.  You will need to identify which areas of the scalp you are sweating from (usually the hairline is a good place to start)  and plan a treatment accordingly.  You may need a couple sessions to determine how much and where you need to inject.

	Good luck!

Raffy Karamanoukian, MD, FACS · Answer

There are many options for neurotoxins that work on the scalp for hyperhidrosis. These options include:

	 

	
		Botox Medical
	
		Xeomin
	
		Dysport


	All three options will exact a benefit for hyperhidrosis.

David Shafer, MD, FACS · Answer

You are in luck - Botox is very effective to stop sweating - even from the scalp.  Botox is commonly used to stop sweating and the scalp is no exception.  You should be able to find a plastic surgeon locally who will inject your scalp for you.  
David Shafer, MD
Manhattan

Michael A. Persky, MD · Answer

Hi Not Luke,
It would be helpful if you could narrow down the exact area of your scalp where the main sweating is coming from.  Botox has been very successful in decreasing hyperhidrosis in the hands and armpits.  It should work as well in the scalp.  Good luck.
Dr. P

Steven L. Greene, MD · Answer

Many patients have localized hyperhidrosis affecting only one anatomic area while others have multiple areas actively affected.
I hope this is helpful to you.
Steve Greene MD

Renita (Lourdhurajan) Rajan, MD, DNB · Answer

Botulinum toxin can be used to give you some good relief from the sweating. The number of units, dosing schedule will depend on the extent of sweating. But yes, this is a good option for craniofacial sweating (sweating of the face and scalp areas). If your forehead also needs to be treated, then your doctor needs to discuss the possible limitations to muscle activity in the treated region.Surgical options like sympathectomy, need to consider the possibility of side effects like compensatory sweating, which can be quite troublesome.Good luck!

Ken Landow, MD · Answer

and wherever the sweating occurs, if it's troublesome or becomes an issue, then botox is there to take up the challenge...and best news yet...your ears still won't wiggle...unlike when botox is used into the muscles for cosmetic issues, it's injected very superficially into the skin for sweat disorders...and of course it works well on the scalp

Steven Wallach, MD · Answer

Although Botox is used for hyperhydrosis of the axilla and hands, I suppose it could be used for the scalp. However, normally 100-200 units is used for treating the more common areas. It may be a bit too much to try to treat the scalp, and I am not sure if it would work well on such a large area.

Hratch Karamanoukian, MD, FACS · Answer

Scalp Hyperhidrosis and Botox, Excessive Sweating - Treatment for Scalp Sweat
Botox can work for hyperhidrosis of any site and requires at least 100 -200 units when applied for hyperhidrosis of the scalp. 
Anyone who has used it for this indication knows that it is a large area and therefore many injections are necessary to accomplish the goal.
It is my professional opinion that Botox is most practical for hyperhidrosis of the underarm followed by treatments for hyperhidrosis of the palms and feet. It is much less practical and less well tolerated by patients when used to treat hyperhidrosis of the scalp.
A more appropriate treatment may be sympathectomy as it does not require repeat treatment. No matter what technique is chosen, it is best to see a hyperhidrosis specialist who has the whole armamentarium to treat you - from your evaluation (comprehensive medical), possible treatment with medication by mouth, Botox injection and finally a sympathectomy.
H Karamanoukian, MD
Center for Excessive Sweating
www.EliminateSweating.com

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