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Botox® for Sweating: A Complete Guide for Clinics & Patients

At the IAPAM, we specialize in trusted training, education, and resources for Medical Aesthetic clinics and their patients—covering everything from injectables to skincare and medical weight loss.

Here, we break down Botox® for sweating (hyperhidrosis): how it works, who it helps, the treatment process, risks, cost, and more.

botox for sweating

What Is Hyperhidrosis?

Hyperhidrosis is a medical condition characterized by excessive, abnormal sweating—often unrelated to exercise or heat. It can affect the armpits (axillary), palms (palmar), soles of feet (plantar), face, and less commonly, other areas.

Key Takeaways Botox® for Sweating

Types of Hyperhidrosis

Hyperhidrosis Types – Responsive Chart
Types of hyperhidrosis and typical treatment areas
Type Description Common Treatment Areas
Primary Inherited/idiopathic; typically affects specific body areas.
  • Armpits
  • Hands
  • Feet
  • Face
Secondary Caused by an underlying condition (e.g., menopause, neurological). Entire body
The condition is common—affecting over 15 million people in the U.S.—and often impacts confidence, work, and social life.

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How Does Botox® Stop Excessive Sweating?

How Botox® Reduces Sweating (Hyperhidrosis)

Botox® for Sweating (Hyperhidrosis): How It Works

Botox® (onabotulinumtoxinA) is a purified neurotoxin that blocks the release of acetylcholine—the neurotransmitter that activates sweat glands in treated areas.

Normal

Nerves release acetylcholine Sweat gland activated Sweating

With Botox®

Nerve signals blocked Sweat gland not activated No sweat (treated area)
FDA‑Approved
  • Underarm sweating (primary axillary hyperhidrosis)
Common Off‑Label Areas
  • Palms
  • Soles
  • Face
  • Scalp
  • Groin
  • Under breasts

Where Can Botox® Be Used for Sweating?

Botox for Hyperhidrosis – Efficacy and Side Effects by Area
Botox treatment by area: approval status, efficacy, and common side effects
Location FDA Approved? Efficacy Common Side Effects
Underarms Yes Up to 90% reduction, 6–7 months Mild pain, bruising, minor weakness
Palms No (off‑label) 25–80% reduction, 3–6 months Hand weakness, injection pain
Soles of feet No (off‑label) 30–60% reduction, ~3–6 months Walking discomfort, soreness
Face/scalp No (off‑label) 40–70% reduction, ~4–6 months Muscle weakness, droop, facial effects

Note: “Off‑label” indicates areas commonly treated in practice but not specifically FDA‑approved for hyperhidrosis. Efficacy ranges and side effects vary by patient and technique.

Note: Efficacy and risk vary by location. Facial treatments must be performed by experts to avoid unwanted muscle effects.

The Botox® for Sweating Procedure: What to Expect

Hyperhidrosis Treatment: Consultation, Prep, Procedure, Aftercare

Botox for Sweating (Hyperhidrosis): What to Expect

A quick overview of the consultation, preparation, treatment, timing, and aftercare.

  1. Consultation

    • Medical history review.
    • Assessment of sweating pattern and previous treatments.
  2. Preparation

    • For underarms: avoid shaving/depilation or deodorant for 2–3 days before treatment.
    • Wear dark, loose clothing to your appointment.
  3. Treatment

    • Skin is marked in a grid pattern.
    • Numbing agent or ice may be used.
    • Fine needle injections just under the skin—usually 15–20 injections per underarm.

Aftercare

  • Avoid rubbing the area, hot baths, or intense exercise for 1–2 days.
  • No deodorant or strong skincare on the treated area for 24 hours.

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How Soon Do Results Appear? How Long Do They Last?

Onset, Duration, and Retreatment Frequency by Area
Onset, duration, and retreatment frequency by area
Area Treated Onset of Effects Duration Frequency of Retreatments
Underarms 2–7 days 6–7 months (range: 4–16) ~2×/year, some need less
Palms/soles 2–14 days 4–6 months 2–3×/year
Face 2–7 days 4–6 months 2–3×/year

Note: Actual onset, duration, and retreatment needs vary by patient, dose, and technique.

Risks, Side Effects & Medical Considerations

Botox for Sweating: Side Effects and Safety

Side Effects and Safety

Most effects are mild and temporary. Serious reactions are rare, but know when to seek urgent care.

Common mild / temporary

  • Pain or bruising at injection site
  • Mild weakness of local muscles (especially hands/face)
  • Headache, flu‑like symptoms
  • Skin irritation or blistering
  • Soreness or tenderness for 24–48 hours

Rare uncommon

  • Sweating in untreated areas (“compensatory sweating”)
  • Allergic reaction (very rare)
  • Muscle weakness in hands/face if injected incorrectly

Emergency

Difficulty breathing, trouble swallowing, or generalized muscle weakness—seek immediate medical attention (extremely rare).

This information is educational and not a substitute for personalized medical advice. Always consult a qualified provider about risks, benefits, and aftercare for your specific treatment plan.

Cost & Insurance

  • Typical underarm session cost: around $1,000 (varies by clinic, country, and dose)
  • Often covered by insurance if diagnosed with hyperhidrosis and prescription-strength topical antiperspirants have failed
  • Preauthorization usually required, with documentation of diagnosis and prior treatment trials

Advantages & Disadvantages of Botox® for Sweating

Pros and Cons – Responsive Chart
Pros and cons of treatment at a glance
Pros Cons
Minimally invasive, non‑surgical Can be expensive if not insured
Quick outpatient procedure, fast recovery Repeat treatments required (not permanent)
Up to 90% reduction in sweat for months Slight discomfort, especially palms/soles
Improved quality of life and confidence Off‑label use in some body areas
Usually covered for underarm hyperhidrosis Risk of mild side effects

Advantages & Disadvantages of Botox® for Sweating

Botox® for Sweating (Hyperhidrosis) – FAQs

Botox® for Sweating: FAQs

Quick answers to common questions about hyperhidrosis treatment.

Is Botox® for sweating safe?
Yes, when administered by an experienced healthcare provider.
How do I prepare for treatment?
No shaving for 2–3 days prior, disclose all medications to provider, wear comfortable clothing.
Will I sweat more in other areas?
Rare, but “compensatory sweating” can happen if treated in large areas.
How long does Botox® for sweating last?
Usually 4–7 months (longest for underarms).
Is it covered by insurance?
Often yes—but you must prove antiperspirant/topical treatment failure and have a diagnosed medical condition.

Conclusion: Botox® for Sweating

Botox® for sweating is a transformative, evidence-based solution that improves comfort, confidence, and quality of life for those with hyperhidrosis. When carried out in a qualified medical clinic, risks are minimal and results are powerful. Both patients and clinicians benefit from practical knowledge, skillful technique, and ongoing follow-up.

For more resources on injectables, skincare, or medical weight loss, and for clinic or provider training programs, connect with the IAPAM—where expert medical education meets real-world patient care.

Disclaimer: The information provided here is for general knowledge only and should not be considered medical advice. For any questions or concerns about your health or medications, please consult your physician or healthcare provider. They are best equipped to provide guidance specific to your medical needs.

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