Botox for armpit hyperhidrosis not worked - is it true it doesn't work well on some people & what can I do?

I can't recall ever having a patient where sweating wasn't at least significantly improved with botox administration. Many patients stop sweating completely for 3-6 months. Most female patients need around 50 units per side, men can require 100 units per side sometimes.

Botox will definitely work for underarm hyperhidrosis. The injections need to be tightly spaced and injected at the right depth. Also make sure they are using Botox or Dysport. The other toxins will not work as well or last as long. In addition, there is a better option....Miradry. Miradry permanently stopped underarm sweat and odor in two treatmemnts. Most of my patients have stopped axillary Botox and received Miradry treatment with immediate and long-lasting results.

Hello, and thank you for your question! While botox under the arms for hyperhidrosis is effective for some, it is not for everyone. There are other treatments available to treat hyperhidrosis. There is a procedure called Miradry. This procedure is usually a one and done treatment. I would recommend contacting your provider to see if you are a good candidate or not. Good luck on your journey!

I would say this is an unusual outcome. Neurotoxins like Botox and others have an amazing track record for reducing sweating by as much as 80%. The dilution of the chosen neurotoxin is important in this procedure because the dilution affects the diffusion. In addition, you might want to consider trying Dysport which may diffuse a smidge more than Botox. Finally, the placement of each injection is critical. Too deep, and the small muscles of the eccrine sweat glands are bypassed as the Botox is injected into deeper tissues. Too far apart and there will be a zone of sweat surrounding each injection site. All of these factors determine treatment outcome, which for most patients, is overwhelmingly successful. For reference, a typical dose for Botox of the armpits would be 100 units divided amongst both armpits. Best wishes.

I am sorry you are having such a frustrating experience! It is unusual for individuals to not respond at all to Botox. I would suggest that a starch iodine test be done to be identify the areas that are still sweating. Typically, most individuals do well with 100 units of Botox per armpit (200 units total), although I do have a few patients that require 150 units per armpit (300 units total). While I am sure your physician is well versed in Botox, another potential failure with Botox is injecting it too deeply. The injection must be very superficial in order to have good effect. It might be interesting to treat one armpit alone, so you would have the other side as a control to really judge whether you have improvement. Finally, I would suggest that you consider miraDry treatment instead - especially if you are paying out of pocket for this treatment. miraDry is the only FDA approved permanent solution for underarm sweating.

Botox for hyperhydrosis is paid by insurance, so I am not sure why it cost you? The FDA approved standard is to inject 50 units in each axilla at 20 sites just under the skin. It typically works very well, but it does not work great for everyone. There are other treatments as well. See a physician who specializes in hyperhydrosis