Botox for Underarm Hyperhidrosis

Botox for Underarm Hyperhidrosis

What is hyperhidrosis

Hyperhidrosis is a medical condition characterized by excessive sweating beyond what is necessary for thermoregulation. This condition can affect various parts of the body, including the palms, soles, underarms, face, and other areas. Excessive sweating can significantly impact daily activities and quality of life.

How Botox treats hyperhidrosis

Botox, or botulinum toxin A, is an FDA-approved treatment for underarm hyperhidrosis, or excessive sweating, because it blocks nerve signals that tell sweat glands to produce too much sweat. Botox works by preventing the release of acetylcholine, a neurotransmitter that binds sweat glands and signals them to release sweat. In people with hyperhidrosis, the nerves that signal the sweat glands are overactive, so Botox injections essentially paralyze those nerves. Botox is most effective for focal hyperhidrosis, which is limited to one area of the body, such as the underarms.


  • Allergies to neurotoxins
  • Amyotrophic lateralizing sclerosis myopathies
  • Autoimmune disease
  • Body dysmorphic disorder
  • Hemorrhagic conditions
  • Keloidal scarring
  • Neuromuscular disorders
  • Pregnant or breastfeeding


  • Botox injections for underarm hyperhidrosis have high patient satisfaction rates of up to 98%: In recent studies, 98% of patients said they would recommend the therapy to others and their symptoms and quality of life improved.
  • Following a treatment, you may begin to experience results within 2-5 days, with full results in two weeks. For most patients, Botox underarm injections last 6-12 months before retreatment is needed. Regular touch-up treatments are recommended to maintain optimal results.
  • You may still need to wear deodorant or antiperspirant, since you won’t stop sweating completely. The goal is to reduce sweat levels to a normal amount.

Risks and side effects

Botox injections for hyperhidrosis in the underarms can have side effects, but most are mild and go away on their own within a few days. Common side effects include pain, stinging, swelling, bruising, redness, itching, headache, hot flushes, and sweating in other areas. Less common side effects include nausea, vomiting, temporary muscle pain and weakness, joint stiffness, and pain in armpits. Serious side effects are rare and include anaphylaxis, difficulty breathing, swallowing, or speaking, muscle weakness, vision problems, dizziness, and loss of bladder control.

What’s a treatment like?

The first step is to clean the treatment areas with alcohol and then apply numbing cream. After the numbing cream is removed, your provider will map the treatment area with about 20 injection sites in each area. The total units used is 100 units (50 units per armpit). Most patients report little to no discomfort during the procedure. The treatment takes about 1 hour from start to finish.

How to prepare for a treatment

  • Shave your underarms 24 hours prior to procedure. This applies to both women and men.
  • Do not apply antiperspirants or deodorants the day of your Botox procedure.
  • Wear a dark-colored shirt that is machine washable. The shirt will be removed for the procedure, but you may rarely get small bleeding spots after the treatment which could discolor your clothing. We recommend that women wear a dark-colored tank top or camisole that can be left on during the procedure.
  • Avoid herbal supplements such as Ginko, green tea, and anti-inflammatories of any kind for two weeks before and following treatment to limit bruising.


  • After your Botox treatment, you may gently clean and dry your underarms with a mild soap or cleanser. Do not massage, press, or manipulate the treatment areas for 24 hours post treatment.
  • You may apply antiperspirants or deodorants 24 hours after your treatment.
  • You may resume shaving 24 hours after your treatment.
  • Although rare, infection in the injected area is possible. Signs of infection may include redness and tenderness in the infected area and fever. Should you develop an infection, antibiotics may be necessary. Please contact us should you have any concerns.

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