Hyperhidrosis – Botox for Armpits

10 Jul

Botox isn’t just used to make you look pretty. It is approved in over 85 countries for over 25 different clinical indications. In the U.S. it is also approved for migraine headaches, cervical dystonia, blepharospasm, strabismus, increased muscle stiffness in elbow, wrist, and finger muscles in adults with upper limb spasticity and symptoms of severe primary axillary hyperhidrosis.


Hyperhidrosis is a condition characterized by excessive sweating, where patient’s sweat up to 5 times more than a normal person. It can be generalized to the whole body (usually secondary to another condition) or localized to a specific area, most commonly the hands, feet and armpits (where there are relatively high concentrations of sweat glands). Although the cause of localized hyperhidrosis is unknown, it is contributed to an over-activity of the sympathetic nervous system. If you have this condition and you get nervous or excited, you’re nervous system is going to cause you to sweat even more.

Severe Primary Axillary Hyperhidrosis

Severe underarm sweating may be exacerbated by stress, emotion or exercise, but often occurs spontaneously. Botox injections were approved as treatment in this area by the FDA in 2004. The effects of treatment are temporary, lasting approximately 6 months. The treatment is used as a last resort when topical medications are not effective. It takes a lot of Botox to treat this area, about 50 units in each armpit, which costs approximately $1,000 -$1,500 depending where you go.

Although Botox is not approved for hyperhidrosis of other areas, that doesn’t mean it won’t work in that area. It is just considered an off-label use. A lot of bartenders Botox the palms of their hands so they don’t sweat. Personally, I’m considering Botoxing my feet. My roommate has several times given me some sort of foot deodorizer as a gift… and she constantly complains about my gym sneakers. I’ve also been known to track foot powder through her living room… Yea… I guess my sweaty feet are a problem.

The Injection Process

The armpit, as most of us can attest to, is a VERY sensitive area. Numbing cream should be applied about 20-30 minutes prior to injections.

Sometimes you can see the sweat glands, it’s usually marked by the hair follicle, but this particular patient had previously had laser hair removal. So I used a powder to help me see where the sweat gland was. As you can see, several rows are injected. A very small amount of product is deposited into the sweat gland at each injection site. The whole process is very fast once it is started; it takes about 10 minutes to do each underarm.

Don’t sweat it.

Happy Summer Everyone! Remember you’re awesome hat and SPF!!!

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