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Botox Injections for Hyperhidrosis

Sweating is completely normal. In fact, sweating is necessary for humans to regulate their body temperature. However, some people perspire far more than is necessary. Hyperhidrosis, or excessive sweating, could have a significant impact on an individual's quality of life. In some cases, sweating is restricted to a single area of the body, like the underarms or feet, a condition known as focal hyperhidrosis. Other cases are more widespread, with sweating affecting many areas of the body. The scalp, hands, underarms, feet, and groin area are the most common areas affected by hyperhidrosis.

Excessive sweating can have a significant impact on a person's life. It can be socially isolating and humiliating; many people find it upsetting.


In 2004, The United States Food and Drug Administration approved Botox for the treatment of excessive sweating of the underarms (severe primary axillary hyperhidrosis) in patients who had not found relief with antiperspirants. 

Botox, which is commonly associated with cosmetic wrinkle reduction, is also an extremely effective treatment for focal hyperhidrosis. Botox injections utilize Botulinum toxin to inhibit the nerve signals, which cause sweating, hindering the sweat glands from producing high amounts of sweat. As the nerves regenerate, retreatment is usually required in four to six months. Patients can go much longer between treatments over time.

Understanding How Botox Works 

Botox injections inhibit the release of the neurotransmitter acetylcholine that binds to the sweat glands and signals the release of sweat. Normally, when your body temperature rises, the nervous system activates the sweat glands. This is how your body naturally cools itself. However, in individuals with hyperhidrosis, the nerves that signal their sweat glands are overactive.

Botox injections directly into sweaty areas of the body paralyze overactive nerves. You do not sweat when your nerves are unable to communicate with the sweat glands. However, Botox only inhibits sweating in the area where it is injected.

  • Palms – There has been little research into the effectiveness of Botox for palm sweating. Studies have established that Botox can reduce sweating by 25 to 50 percent for three weeks to 6 months.
  • Face – Botox may help treat facial sweating. Botox has been shown in studies to reduce facial hyperhidrosis for five to six months; a common side effect is paralysis of the forehead muscles.
  • Soles of the feet – Although few studies have been conducted, Botox could help control sweating on the soles of the feet. In a 2018 studyTrusted Source,  73 percent of people aged 12 to 17 were pleased with their outcomes.

Effectiveness of Botox in Treating Hyperhidrosis 

Previous treatments for excessive underarm sweating (axillary hyperhidrosis) were frequently ineffective and short-acting and were often associated with significant risks.

According to studies, 80 to 95% of patients usually respond to a single treatment session (Naumann, 2001; Lowe, 2003; Naumann, 2003). Injections can improve your quality of life (Campanati, 2003) and reduce body odour (Heckmann, 2003) for up to seven months (Naumann, 2003), in addition to decreasing perspiration. A study done over the long term found that side effects are negligible and recurrent injections over 16 months are safe and effective, with 96% of patients experiencing a 50% or greater cut in sweating after the first treatment (Naumann, 2003).

What to Expect

Your appointment will probably last 45 minutes, though the injections only take 20 to 30 minutes. Botox injections are most effective when administered by a trained professional. Injections are quick and can be done during a single visit. A professional will use ink to mark your skin and inject Botox beneath the skin's surface using a fine needle. You'll get 15 to 20 injections, usually in a grid pattern around the problem area. Some doctors may give you a little bit more.

You can go back to work and normal life as soon as your Botox injections are completed. The practitioner will most likely request a follow-up appointment to touch up any missed areas.

You ought to be able to leave immediately following your procedure. In general, little aftercare is required. For the next day or so, you may experience tenderness around the treated area.

Your doctor will most likely request a follow-up appointment about two weeks after your appointment when the Botox has taken full effect. Any missed spots may necessitate an additional procedure.

To avoid irritation, doctors frequently recommend avoiding deodorant or perfume-containing products under your arms for 12 to 24 hours. Avoiding strenuous exercise as well as hot baths for 1 to 2 days may also be beneficial.

The Possible Side Effects 

Many studies have been conducted to assess the safety of Botox in treating underarm sweating. The majority of people tolerate it well. Fewer studies have looked into the safety of Botox when injected into other parts of the body to stop sweating. The possible side effects include:

  • Skin irritation
  • Pain or bruising at the injection site 
  • Headache
  • Bleeding 
  • Flu symptoms 

Severe side effects of Botox are extremely rare and only occur when the Botox affects your whole body. Severe effects could include:

  • Trouble seeing 
  • Muscle weakness
  • Loss of bladder control
  • Difficulty breathing 

Overcome Your Sweating Problem

Botox is safe and effective for treating excessive sweating in the armpits, head and face (craniofacial), feet, hands, and other relatively small body areas (such as under the breasts). Botox has been shown to reduce sweating by 82-87% when used to treat excessive underarm sweating. Results are usually visible 2 to 4 days after treatment, with full effects usually visible within two weeks. Dryness usually lasts 4 to 12 months, but some studies have shown that it can last up to 14 months. 

Botox for hyperhidrosis treatment is most effective when administered by a clinician with special training and experience with the procedure.

Approved Indications for Botox