Botox for Hyperhidrosis

Botox for Hyperhidrosis:Botox Hyperhidrosis Treatment
Another very popular method to treat focal hyperhidrosis is the injection of Botox. It is a well known chemical structure used a lot by plastic surgeons to treat wrinkles. Over the years more clinical indications were added to the list and now Botox is used for different medical and surgical specialties. Botox has some chemical activity that amongst others competes and blocks the transmitter which is secreted by nerve endings for the production of sweat.

In cases of focal hyperhidrosis Botox was found to be of temporary help mainly in cases of axillary (armpit area) sweating. It has a temporary effect which can last between two to six months. It is also approved by the FDA for that purpose. On the other hand in cases of palmar (hands) and plantar (feet) hyperhidrosis, Botox is not FDA approved. Pain can be a problem when injected into the palms or the plantar surfaces (hands and feet). Some sort of local or regional anesthesia may be required. On the other hand the pain is very well tolerated when injected into the armpit area.

What is Botox:
Botox is a derivative of the botulism toxin but in small amounts, and injected into the right places, can be used safely. It is produced from spore forming bacillus Clostridium botulinum. The way it works is by blocking the neurotransmitter responsible for sweat production. A new product by the name of Myobloc is also available for the treatment of focal hyperhidrosis especially axillary hyperhidrosis (armpit sweating). Basically this is a different name for the same product. It is based on certain toxins produced by bacteria and perfected for the use in cases of hyperhidrosis.

Effectiveness of Botox with Hyperhidrosis:
With regard to effectiveness of Botox for hyperhidrosis it should be remembered that Botox has a limited and temporary effect. Repeated injections will increase the bodies resistance to the material. It is more effective in cases of armpit sweating (axillary) and less in cases of palmar and plantar hyperhidrosis. Another drawback may be the cost which is typically several hundred dollars for each treatment. In order to offset the price patients can try and ask for insurance coverage.

If money and pain are not of an issue then Botox can be tried to treat focal hyperhidrosis of the armpit. With regard to palmar (hand) and or plantar (feet) hyperhidrosis at present there is no good indication to the usage of Botox.

Join the Discussion for Botox and Hyperhidrosis:
Post your comments or questions below, we will do our best to reply.




Does Botox work well for some more than others? How effective is it for sweaty hands?

Hands and feet

I have had Hyperhidrosis since puberty over 40 years ago . The doctor described my condition as severe . The only area that really concerns me is my hands . Shaking someone's hand is very embarrassing and comes along with an explanation as to why my hands are so wet . That being said , the only treatment that has worked for me is the Botox injections . For me the treatment lasts about 6 to 9 months at a cost of around a thousand dollars a treatment for one hand . The doctor uses one needle to inject the Botox . Twenty three separate injections in your hand and it's quite painful . They have you hold an icepack for a few minutes before the treatment begins . If you have a low tolerance for pain I would suggest asking for a local and have it applied before the procedure begins . Most insurance companies will cover the cost of the botox as it is used for a medical condition.Just have the doctor call in the prescription to your local pharmacy and keep it refrigerated until the time of your appointment . Good luck !

Botox - Hands and Feet

Thanks for sharing your comment which is a very important one. I'm happy for you that the Botox injection treatment is helping you and that you can tolerate it well even though it is very painful. Not every patient will respond that way and as I have discussed with many patients, Botox injections did not help them at all or for a very short time. You might be in a unique situation so continue with that treatment which gives relief for 6 months. If that treatment fails because of the fact that the body develops tolerance to the Botox injections then in the severe cases the option of ETS is still a viable one. Again thanks for your comment.


Thanks for the comment. First and foremost Botox is FDA approved for the treatment of excessive hand and feet sweating. The treatment with Botox is only of temporary help if at all. It is costly, painful and at times weakness of muscles in the hands were noted. We know that a lot of dermatologists are encouraging the trial of Botox but this comes from different motives. There are other conservative measures that are recommended. Please see our alternative methods in the navigation.

Botox treatment for Hyperhidrosis

Can you tell me if you can use your HSA account to pay for the treatment of Hyperhidrosis with Botox?

re:Botox treatment for Hyperhidrosis

HSA's (Health Saving Accounts) are interpreted differently by the authorities. Since hyperhidrosis is a non-lethal or acute problem the authorities do not always allow or recognize expenses made on HSA accounts as legitimate or justified. At present Botox injections for hyperhidrosis are not being paid by insurance companies. Having said that, each case has to be checked on an individual basis. If you want to explore this option better you can call our office and find out.

Can botox injection be used

Can botox injection be used for facial hyperhydrosis, in may be 24 year old \male ? What do u suggest in that case?
Thank u for your time

Re: Botox injections for facial hyperhidrosis

Thank you for the question. Unfortunately Botox is not a good method to control facial sweating. In the face Botox is used by dermatologist and plastic surgeons for wrinkles etc. To inject the sub dermal layers around the face with Botox is not used and I do not believe it is a good solution for facial sweating. You should try certain pills such as anticholinergic agents for hyperhidrosis. In any case I would not recommend you to have Thoracic sympathectomy when facial sweating is your only presentation of hyperhidrosis.

Botox injections for facial sweating

I would like to discuss with a professional about my facial and now back sweating. I had the surgery over a year ago and the sweat instead of on my face is now more on my face, back, and back of legs. Tried other meds to no avail. This has always been a psychological problem, but along with meno-pause it has gotten worst. I can't dress in the morning or put on make up to go to work. Can't shop, can't go out to dinner or to the movies without sweating. I am depressed most of the time. My life is around trying to stay dry and I am losing. HELP

My doctor is Dr. Malcolm Brock at the Johns Hopkins Hospital in Baltimore, Maryland.

re: Botox injections for facial sweating

Thanks for your comment. The first thing I would like to state is that endoscopic thoracic sympathectomy is not an efficient and justified method to deal with facial hyperhidrosis. Some of the surgeons who are performing ETS are not familiar enough with the fact that the operation should not be done for facial hyperhidrosis because of it's limited success rate. At the same time doing the procedure for facial hyperhidrosis harbors a very high chance of developing intolerable compensatory sweating. This observation came after following patients who had the operation done for that reason. For that reason, hyperhidrosis authority, Dr. Reisfeld from Los Angeles discourages patients and doctors alike from doing this procedure specifically for facial hyperhidrosis. The place where you were operated upon is a very well respected surgical institution however we do not agree with this approach.

I have just gone for

I have just gone for treatment of Hyperhidrosis. My issue is in my hands, although I have problems in all areas, feet, armpits, groin area. I received 40 units of Botox yesterday and have seen no results yet. I am wondering if I just threw money down a pit, or if it has worked for anyone? My concern is that the last time I went for Botox in my forehead it seemed to do nothing for my frown lines, could my body be resistant to Botox?

I have been receiving Botox

I have been receiving Botox for that last 2 years and have seen excellent results. I go in every 3 months. It takes about 3 days from the first day I receive my injections to see results. After that NO sweat or need for deodorant. Truly a blessing not having to deal with excessive sweating. the only down fall, painful injections. I had it done by a neurologist who was randomly injecting me, with her I seen No results! However, With my new neurologist....she cleans the armpit with alcohol, then sprinkles with cornstarch, it turns purple showing her were the glans are over active and that's were I get the Botox injections, giving me excellent results! It's painful but worth it.

re: Botox injections

Indeed Botox is known to help with isolated axillary sweating. Not everyone gets the same results and there are cases where even with Botox injections the results are very disappointing. I believe it has to do with certain antibodies that some patients might have in their blood against the poisonous material. You should be very happy that you get this help but with time I guess you will also develop immunity against it. As long as you get good results and money is not a problem, continue.


I also have had an issue w/ this for years(hands, feet). Much more prominent in summer. Have you found any relief? I was prescribed a generic for Procardia XL 30mg.(Nifedical 30 mg.) a few months ago. It only takes the edge off.
I have had it all my life, and I literally drip at times, especially in high stress. I recently went to my endrochinologist(thyroid dr.) and found out Nifedical was a blood pressure med. I had my thyroid removed because of a goiter 5 yrs. ago.He prescribed me something else called Glycopyrrolate 1mg. tab, 3X's a day which I haven't taken yet. Do you or anyone know anything about this drug or it's success?

Re: Hyperhidrosis

Thank you for the question and background information. Basically patients who suffer from severe cases of hyperhidrosis will not benefit that much from different medications. The one you described are used on a trial basis but the success rate is minimal or none. The last one you mentioned Glycopyrolate is one of the most commonly used medications to treat hyperhidrosis, and I recommend you try it, and you might get some relief but again the benefits would be for a short time if at all. If you find any help you can continue with those medications or try other ones from the same family. See our medications page. In the future if you have anymore questions do not hesitate to get in touch with me here or by calling us (310) 557 3037.

Re: I have just gone for

Thank you for your message. As a rule Botox is not recommended for palmar or plantar hyperhidrosis. It has some limited use (time wise) when you treat axillary hyperhidrosis. It is not FDA approved for the treatment of palmar and plantar hyperhidrosis so it is not recommended. Not only because of the financial burden but because it is ineffective and difficult to perform because of the associated severe pain. With regard to the treatment of facial sweating with Botox, it is also very questionable. Contact us anytime for more specific information to your condition.

Dr. Reisfeld

I have used Myobloc for this for years

Hands, feet, and underarms. I do find there is a difference between Myobloc and Botox. Botox breaks through for me in about 2 weeks where Myobloc lasts up to 12 weeks. I have a very severe case though and am now considering surgery just due to the side effects of so much being injected.

Re: I have used Myobloc for this for years

Myobloc is another form of the Botox toxin. Different chemical formulation can produce different results. You might have gotten a better response with Myobloc compared to Botox but it still has a limited overall effect. As you go back to more treatment the efficacy of that treatment will go down. For more information on the surgery and if it is right for you please contact us, we would be happy to assist you.

Sweaty hands and feet

I would like to go for the botox injections. Which steps should i follow?

re: Botox Injections

Botox injections are one of the conservative measures that can be taken to treat focal hyperhiodrosis. The FDA has not approved Botox injections for the treatment of palmar or plantar hyperhidrosis. So far it provides temporary relief for axillary hyperhidrosis. With regard to palmar and plantar hyperhidrosis it can be used but with the understanding that it is going to be on a temporary basis, painful and expensive. If a person has the means to go for it then it could be tried bearing in mind that side effects of muscle weakness and pain are part of this treatment.