I got 300 units of Botox underarm sweating and sweating worse than before. What could have gone wrong?

Question

I typically get 100 units in each underarm every 4 to 6 months and it worked great but it would wear off so this time I tried 150 units per underarm and i have more sweating than the previous 100 unit treatments! The only difference is that I changed doctors and this doctor does the injections slower. Please help

Harold J. Kaplan, MD · Answer

Hi BR.  As another physician has mentioned, Botox (Dysport) injections do depend on the skill of the injector so if you were injected by someone that was not trained well on underarm injections, then it's possible the product could have wound up at the wrong depth.  If it was working with your previous injector, best bet is to return to that person.  Best of luck.

Jason Emer, MD · Answer

I recommend getting a formal evaluation with a cosmetic dermatologist for hyperhidrosis. Botox works well for improving excessive sweating, however if you have significant amounts you may need oral treatments like glycopyrrolate or surgery. See an expert. Best, Dr. Emer

Nicholas Gentry, MD · Answer

I typically use about 40-50 units per side injected in 20 locations. If you inject the Botox too deep, it will not work well. If you are getting Botox brand, 300 is too much to be injected in my opinion. I would consider Miradry as this is usually about 1700-2000 and has average of 82% permanent sweat reduction.

Monika Soni, MD · Answer

Thank you for your question. Botox injections depend on the skill of the injector and from your description it seems like your injections were done at wrong the depth. I recommend returning to your injector who your previous injections were working well with. Best of Luck!

Eric YK Li, MD · Answer

If the number of units injected increased and the treatment areas remained the same, then it is likely your injector placed the Botox too deep for the clinical effect to be on the sweat glands, which reside in the dermal layer of your skin.  I would recommend seeing your injector again for re-evaluation.  As always, seek proper consultation before treatment and best of luck!

Kurt Kuhlman, DO · Answer

I inject only 50 units per axilla (20 sites with 2.5 units per site just under the skin) for hyperhydrosis and get great results for about 6 months. FDA approval was for 50 units per axilla and most insurance companies will not pay for more than this.The most likely answer is that your injector went to deep with the needle.

Alix J. Charles, MD · Answer

Thanks for your question.  There really isn't a "scientific" explanation for why your results would vary so much.  I think it is probably a difference with the injector.  I would have your first injector try for you again. Best of luck to you!

Melvin Elson, MD · Answer

This is one of the areas that Botox is most effective and the problem most likely is the technique so go back to the doctor who got good results

Leonard Grossman, MD · Answer

I think you may have answered your own question already. Most people need only 50 units of Botox per underarm area. Receiving more Botox in the amount of units will not last any longer. Good luck from New York City

Kristine Brecht, MD (license suspended) · Answer

More Botox will not necessarily make the Botox effects longer if it is placed properly to start with.
It lasts 2.5-6months, hopefully your side effect will wear off sooner than later.
Best. Dr Brecht
Seattle, Wa

I got 300 units of Botox underarm sweating and sweating worse than before. What could have gone wrong?

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