Botox to Treat Gustatory Sweating?

I am suffering from Gustatory Sweating (my face starts to sweat when I eat) and I was wondering if Botox would be able to help me treat this condition. I have read many medical journals and I found out that since Botox is used for hyperhidrosis (excessinve sweating) of the armpits, hands, and feet, Botox A injections can be used to treat my condition as well. I consulted a doctor, who sadly, told me that she could only administer such on my forehead, as it would give a paralyzed look if put anywhere else on my face. My problem is that most of the upper half of my face (nose, surrounding area, temples, and forehead) is afflicted. Is this true, or would a special technique be necessary to get this condition treated?

Doctor Answers 7

Botox for Gustatory Sweating and Excessive Drooling

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Not only has Botox been helpful in patients with Frey's syndrome (gustatory sweating)but a study published in 2004 showed that there can be dramatic reduction of salivary flow in patients with drooling, salivary fistulas, or chronic sialadenitis by local injection of Botox.

In an extended report, the authors showed that in 33 patients, the effect of Botox lasted for approximately 3 months. Based on their results, the authors recommend Botox injection as the therapy of choice in patients with the problem of drooling.

Gustatory sweating and Botox

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Botox has been used effectively for gustatory sweating in patients that have this pathway usually after previous parotid gland surgery.

Botox Is Effective and Safe for Gustatory Sweating

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Botox binds to and temporarily deactivates a specific type of nerve.  This type of nerve activates voluntary muscles (things like your heart and bowels are not voluntary), sweat glands, and saliva glands.  Gustatory sweating (Frey's Syndrome) occurs when the nerve that is supposed to go to your saliva gland gets cross wired (usually from trauma/surgery) and instead activates sweat glands on the cheek.

Botox can be injected superficially into the skin, sort of like an allergy test patch, to block the sweat glands in the skin.  A skilled injector can do this with only a very minimal risk of affecting the muscles deep to the skin.  I have treated several patients for gustatory sweating with excellent results lasting about 6 months.

Botox for Gustatory Sweating

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I have successfully treated many patients here in San Diego for this exact problem. You have to be very careful how you inject the Botox for this particular problem as it is different than injected Botox for unwanted muscle movement. There is always a chance that the Botox can migrate deeper and affect the underlying muscles - thus leading to a partially paralyzed look. However, this can hopefully be minimized by going to an experienced Botox injector.

John M. Hilinski, MD
San Diego Facial Plastic Surgeon
4.7 out of 5 stars 44 reviews

Gustatory Swelling may be treated with Botox

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Since the arrival of Botox, many non-cosmetic options have been found for this important medication. Gustatory sweating may be treated with Botox. The most important thing is to find a physician with excellent knowledge of facial nerve anatomy and experience in treating Frey’s syndrome.

For more information on Botox or to schedule an iConsult, please visit us online at: 

There are reports of Botox being used for gustatory...

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There are reports of Botox being used for gustatory sweating. In this regard, I woudl suggest visiting with either an ENT physician or a facial plastic surgeon who was trained as an ENT physician. ENT physicians deal with gustatory sweating after facial surgery as a matter of their training. In some cases, additional surgical procedures can be performed which can help the sweating. As the physician you consulted pointed out, improper injection for gustatory sweating can produce facial paralysis so care must be taken during the injection process.

D.J. Verret, MD
Dallas Facial Plastic Surgeon
3.9 out of 5 stars 14 reviews

This is an excellent question. Gustatory sweating is...

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This is an excellent question. Gustatory sweating is often caused by a previous surgical procedure on the face, either cosmetic or reconstructive. There are several options for treatment, including surgery, but there are reports in our Plastic Surgery Literature of folks using Botox to control it. This is a procedure that, just like all Botox treatments, should be administered by an experienced injector, but it can be done. The downside: besides the risks of causing facial asymmetry, any benefit will be temporary and will require multiple treatments througout your life.

Surgical treatments, including placing a dermal graft or a piece of Alloderm as a spacer between your skin and the underlying tissues, is an excellent option and will usually provide a very nice and durable result, it is placed thorough a standard hidden facelift incision, and can be a permanent solution.

Bottom line: talk to a plastic surgeon not only skilled in cosmetic surgery but also in reconstructive surgery-- this person will be uniquely trained an dqualified to lay out your options for you.

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.