Can Botox Treat Hyperhidrosis?

Can Botox treat hyperhidrosis? Is this Botox hyperhidrosis treatment approved by the FDA or just experimental?

Doctor Answers 34

Botox, or botulinum toxin type A, was approved by the...

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Botox, or botulinum toxin type A, was approved by the FDA in 2004 for the treatment of severe primary axillary hyperhidrosis (excessive underarm sweating) that is inadequately managed with topical agents. Botox can also be used for excess sweating in other areas, though this is technically an off-label use.

Currently, in the United States, botulinum toxin type A is marketed only by Allergan Corporation under the name Botox and Botox Cosmetic. Some insurance companies will reimburse the cost for Botox injections for hyperhidrosis. Though Botox and Botox Cosmetic are the same compound, if insurance reimbursement is being sought, it is imperative that Botox and not Botox Cosmetic be used.

For axillary hyperhidrosis, definition of the area to be injected is performed first. This can be done in several ways. Once the area is defined, the recommended starting dose is 50 units per axilla.

According to Allergan the most common side effects included injection site pain and hemorrhage, non-axillary sweating, infection, pharyngitis, flu syndrome, headache, fever, neck or back pain, pruritis, and anxiety.

Dallas Facial Plastic Surgeon

Absolutely. Botox is an excellent treatment for under...

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Absolutely. Botox is an excellent treatment for under arm hyperhidrosis.
Excess under arm sweating can be diagnosed with a simple in office exam using iodine and starch powder. The area is then injected with Botox just below the surface of the skin, covering the entire area of staining. Typically 50 units are used in each under arm area. My patients experience a dramatic reduction in sweating and the treatments last about 6-7 months. There are no significant complications from the superficial injection of Botox.
Botox is sold as Botox and Botox Cosmetic. When there is a possibility of insurance reimbursing the treatment, which is rare, Botox must be used.

Robert W. Kessler, MD, FACS
Corona Del Mar Plastic Surgeon
5.0 out of 5 stars 130 reviews

Botox is a great, but temporary treatment for hyperhydrosis

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Botox®, the commercially available form of Botulinum toxin type A, is a very effective, but temporary treatment for hyperhydrosis (sweaty palms, sweaty armpits, etc). The reason for this is that the receptor that activates the sweat gland is very similar to the one that exists between motor nerves and muscles (in the forehead, crow's feet, and glabella).

My personal experience is that Botox® lasts longer when used for this indication than it does for hyperdynamic facial lines, lasting up to 6 months. The way Botox® is administered is via multiple shots with a very small needle to the skin of the affected area.

My experience is that patients will generally require about 100 units (for both armpits) to achieve a result they are happy with. As with other indications for Botox®, the result takes 3-7 days to become obvious.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.9 out of 5 stars 104 reviews

Botox for hyperhidrosis - Relief for 7-17 months!

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Botox is an amazing and effective treatment for hyperhidrosis (excessive perspiration). We utilize it most commonly for the axillae (underarms) but also use it for the palms, soles and for focal areas in which patients complain of sweating, such as the forehead.

It works by diminishing the sweat secretions of the eccrine glands. You must be sure that your dermatologist rules out any underlying metabolic disorder causing the excessive sweating, though those cases are uncommon.

It is a fast procedure, sometimes reimbursable by insurance companies, and can give relief from 7 to 17 months!!! It has changed many of my patients' quality of life, and I get only positive feedback.

Laurie Polis, MD
Manhattan Dermatologic Surgeon

Botox is a great way to treat...

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Botox is a great way to treat hyperhidrosis!

Hyperhidrosis is a medical condition where people sweat excessively, in situations unrelated to the temperature/weather. It is most common under the arms and on the palms and soles, and can cause a lot of anxiety in those affected.

Botox is FDA-approved to treat hyperhidrosis under the arms. It takes about 15 minutes, and the effects last about 6 months. Because the underarms are a pretty fleshy area, the injections are not very painful, but I apply a numbing cream for 10 minutes prior to the treatment.

Jordana S. Gilman, MD
Washington Dermatologic Surgeon

Botox for underarm hyperhidrosis is Effective

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Botox for hyperhidrosis of the underarms can be very effective and is one of the areas of the body where Botox is most well tolerated in terms of discomfort with injections. The effect can last anywhere from 3 months to 6 months or more. Once the individual becomes tired of repeated injection, or in the rare situation where the effectiveness diminishes, then there are other good options to treat hyperhidrosis of the underarms such as dermatosuction or endoscopic thoracic sympathectomy (ETS, micro ETS).

Botox is an excellent treatment for hyperhidrosis (sweating)

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I have been very happy with the results from using Botox to treat excess sweating in the axilla (underarms). Most of my patients have experienced a significant decrease in sweating for 6 to 9 months. The procedure is relatively painless and although it appears costly at first, think of all the clothing that you have damaged over the years due to excess sweating.

I have also treated a patient who developed localized sweating on the forehead and temples and scalp after chemotherapy treatments and she had excellent reduction in sweating for 6 months.

Consider it a safe option for hyperhidrosis!

Brenda Dintiman, MD
Fairfax Dermatologic Surgeon

Other Options for Axillary Hyperhidrosis

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While Botox is very successful at treating axillary hyperhidrosis, it is temporary. A longer-lasting option that is also very effective is superficial liposuction of the axilla.

Recently, superficial subdermal treatment with the 1064 nm or 1320 nm laser has been shown great promise. These treatments help to eliminate the sweat glands that produce sweat in this area, and have been demonstrated to be very safe.

Brett S. Kotlus, MD, MS
New York Oculoplastic Surgeon
5.0 out of 5 stars 63 reviews

Botox for axillary hyperhidrosis

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Typcial results from Botox injections to the armpit area is a 50-80% reduction in sweat production. This is often the perfect amount since some sweat function in this area is essential as a normal process of your body.

The armpit skin isn't that sensitive, and patients tolerate it very well, by evidence, that they always return for repeat injections. If you don't get enough of a result, then your physician can increase the dose in 3 months for your next treatment

Botox is great for sweating

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Botox works by inhibiting a neurotransmitter, Acetylcholine, from being released. This happens to be the same neurotransmiiter used for moving muscles, and to produce sweat.

It shouldn't be the first thing you try for excessive sweating, but if everything else fails, it's great for underarms, hands, and feet.

Hands and feet are a little more painful and sometimes require blocks, but results are dramatic. About 100 units of Botox are needed to do the underarms (total for both), and the same for both hands.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.9 out of 5 stars 75 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.