Dysport for Hyperhidrosis or Visit a Dermatologist?

I believe I suffer from hyperhidrosis in my armpits, hands, and feet. Should I visit a dermatologist or go ahead and try Dysport?

Doctor Answers 11

Dysport for Hyperhidrosis

Dysport for axillary (armpit) hyperhidrosis (sweating) is highly effective.  Equivalent neurotoxins include Botox and Xeomin.  All are effective, but the duration of action will depend on how much you put in.  It can last anywhere from 2-6 months.  miraDry is a new device that permanently reduces sweating.  It requires 2-3 treatments and can be as effective as Dysport, but once you've completed your treatment series, you are done.  Axillary shaving is a techique that I use to surgically remove the sweat glands from the armpits.  This is also a permanent reduction in sweat.  All three options are effective, but in the long run, the Dysport option becomes the most expensive as you have to repeat this 2-3 times a year.  My recommendation is start with miraDry and use surgery as your last resort. 
Regarding who you should see, a Dermatologist or Plastic Surgeon are both well versed in treating hyperhidrosis.  I'm a plastic surgeon and my partner is a dermatologist and we both treat hyperhidrosis using non-invasive methods.  In addition, I have the added benefit of using surgery as a back up for patients who don't respond to these measures.

Hope this helps. 


Houston Plastic Surgeon
4.8 out of 5 stars 35 reviews

Axillary hyperhidrosis and treatment

You should really do both. Botulinum toxin can only be adminstered by a physician so this is not an either/or choice. You need to see an physician and have the Botox/Dysport injected.

There are other options for axillary hyperhidrosis including surgical approaches if you seek a longer term solution.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

Miradry instead!

Our office specializes in Miraday. Miradry just got FDA clearance for elimination of all hair colors under the arm. It also has clearance for the elimination of underarm sweating and odor. Much cheaper than botox/dysport and permanent.

Sheila S. Nazarian, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 56 reviews

Dysport for Hyperhidrosis or Visit a Dermatologist?

Botox and Dysport is a great option and highly effective helping excessive sweating, most patients require 50 units per axilla with Botox or 150 units per axilla with Dysport. Its best to seek a reputable provider with much experience in treating Hyperhidrosis

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Hyperhidrosis for the armpits

Dysport, like Botox, can eliminate hyperhidrosis of the underarms, feet, and hands.  A hyperhidrosis expert should perform the injections.

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

Hyperhidrosis of the Underarms, Palms and Feet

Hyerhidrosis of the underarms, palms and feet can be treated together in one shot using a technique called ETS - endoscopic throacic sympathectomy and costs anywhere from 10,000 to 21,000 USD depending on where you live.

If the underarms are your only concern, you can get repeat Botox injections every 3-4 months. If you want a permanent treatment for underarm sweating, the miraDry procedure uses microwave technology but is not covered by insurance.

For hyperhidrosis of the palms and feet, consider Botox injections

Hratch Karamanoukian, MD, FACS
Buffalo Phlebologist
4.8 out of 5 stars 41 reviews

Botox or Dysport for Hyperhidrosis

Both Botox and Dysport work well for Hyperhidrosis.  In general, 100 units of Botox is necessary and 300 units of Dysport is necessary to have a nice effect.  There really is no cost difference between Botox and Dysport so whichever your injector recommends will likely do well.


Good Luck.

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 75 reviews

Botox or Dysport for hyperhidrosis: only after other treatment failures.

Before trying the effective, but expensive and cumbersome, neuromodulators for excessive underarm sweating, see your dermatologist for suggestions on various methods to try first. There are several steps that may work effectively, and without going through these, no insurance company would pay for this treatment anyway, so the expense would be daunting.

If you diligently try and fail other methods for medically problematic excessive sweating, then many insurance companies will cover the cost of Dysport or Botox. Like cosmetic uses, these treatments need to be repeated every few months. If you do find you are ready for the treatment, your dermatologist can perform it.

Jessica J. Krant, MD, MPH
New York Dermatologic Surgeon
4.7 out of 5 stars 41 reviews

Try other treatments first

There are a range of other treatments available besides Botulinum toxin. In fact, most insurance companies require a prior treatment before they will approve BOTOX or Dysport for axillary hyperhidrosis.

The first and simplest treatment is topical. This would be a prescription strength antiperspirant such as Drysol. Drysol can be fairly irritating and a newer version should be released shortly.

Second some people have success with a Drionic device. This works using a type of electrolysis. R.A. Fisher Company makes a good one. At the beginning you might have to use this device every day, but after awhile every third day should suffice.

Medications in the anticholinergic class are also often tried. These include such medications as Probanthine or Robinol . The problem with them is that side effects usually intercede before the therapeutic dose to treat hyperhidrosis is reached. Still they can be attempted.

Also, there is a surgical approach in which the nerve chain which causes the sweating is transected. I have not personally found this all that successful in my patients, but still this is a very valid option.

Then, of course, there is BOTOX. It does work and works for 6-9 months. Although Dysport has not been FDA approved for this indication, it may be more effective than BOTOX. Dysport diffuses better than BOTOX. The problem here is that insurance companies will not approve Dysport yet, so this would be a totally out-of-pocket expense.

I should also like to add that you should be worked up for a medical problem such as hyperthyroidism which might be causing your problem.

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist
4.7 out of 5 stars 14 reviews


Axillary hyperhidrosis can be treated with Botox or Dysport with fairly effective results. These results usually last approximately 6 months and need to be repeated. There are reports in the literature about the effectiveness of the SmartLipo laser (or any other form of laser liposculpture - ProLipo, SlimLipo,etc) to treat this condition. Although SmartLipo is mainly to remove fatty areas, it has been found that the heat generated beneath the skin (dermis) can effectively and sometimes permanently reduce or eliminate the hyperhidrosis.

Theodore Katz, MD, FACS
Philadelphia Plastic Surgeon
4.8 out of 5 stars 7 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.