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For the approximately 15 million people living with hyperhidrosis, a largely underdiagnosed condition where the body’s sweat glands are overactive throughout most of the day, just the thought of perspiration can lead to crippling anxiety. Lots of people can wipe away a sweaty brow or wear an undershirt on a hot summer day to avoid stains, but those who are chronically sweaty aren’t always even impacted by temperatures or physical activity in their day. Hyperhidrosis is characterized by sweat that soaks through clothes in specific places, even when simply lounging in a cool room — it may also be frustratingly limited to a problem area, like forearms, thighs, or even behind your knees.
Spending any time thinking about how you’re going to mop up or hide away excess sweat during the day is a likely indicator that you may be suffering from hyperhidrosis — but which kind? Healthcare providers at the Mayo Clinic explain that there are two different kinds of chronic excess sweating that can affect individuals, with two distinct roots causing the issue at hand.
The most common form is known as primary focal (or essential) hyperhidrosis, tied to nerves that regulate sweat glands; they trigger sweating without a rise in body temperature or physical activity. This kind of hyperhidrosis is also made worse by stress or nervousness, which is why people can begin profusely sweating just thinking about, well, sweat. This version usually affects your face, your palms or the soles of your feet, and it may be hereditary in nature, explains Desmond Shipp, M.D., a practicing dermatologist at The Ohio State University Wexner Medical Center.
Regardless of the kind of hyperhidrosis you may be dealing with, treatment for overactive sweat glands always almost starts with a troubleshooting session with a caregiver. Dr. Shipp tells Good Housekeeping that he tries to pinpoint any specific triggers for the condition and determines whether or not it presents in a specific area or region, in addition to doing a sweep of medical history that addresses any potential coinciding sweating symptoms. Sometimes, your urine or blood may be tested to confirm there isn’t an underlying condition like hypoglycemia or hormonal imbalances.
At first, those dealing with excess sweat will almost always be asked to try a topical treatment in swapping the kind of deodorant in use, says Erika Schwartz, M.D., author and a New York City-based internist in private practice specializing in holistic services. “Topical aluminum chloride-based antiperspirants are the first line of treatment; however, they may not be the most effective,” she adds.
If the sweating is concentrated away from armpits, or if a new antiperspirant doesn’t solve the issue, some experts will consider electrical iontophoresis treatments on hands, feet or facial regions to stem sweating. Oral medications like glycopyrrolate and oxybutynin, both of which block sweating as side effects rather than primary functions, could also be added to the mix, Dr. Shipp explains.
However, medications aren’t always an option for patients, nor electrical-based skin treatments, which is why many providers move onto Botox for sweating in trouble areas.
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Can Botox be used for excessive sweating?
Primarily made with a toxin derived from the same microbe that leads to botulism (a severe form of food poisoning), Botox has become known for its ability to practically erase facial wrinkles. But the method in which Botox works to reduce the appearance of wrinkles on the face — where the toxin within temporarily prevents facial muscles from moving over time — can also indeed be used to target overactive sweat glands.
“Botox works to treat hyperhidrosis by blocking the nerve signals that communicate with sweat glands,” Dr. Schwarz explains, adding that it can work to reduce the severity and frequency of chronic sweating up to 85% overall.
The science behind why Botox may help afflicted patients with routine, profuse sweating has to do with the fact that botulinum toxins inhibit the release of acetylcholine, a natural neurotransmitter that “plays an essential role in causing the nerves’ sweat to be released,” Dr. Shipp adds.
Unlike antiperspirant, which is usually limited to under one’s arms or on easy to reach regions of body skin, Botox can be injected into trouble areas on your forehead, hairlines or the back of your neck, for example.
Botox treatment providers for hyperhidrosis patients within University of Minnesota Health indicate that patients can begin seeing a decline in excess sweating within five days. They note that Botox treatments for sweating are best when it’s limited to one area of your body, although some areas (like hands) may be at elevated risk for muscle weakness over time.
Editor’s Note: Because Botox may affect muscle development for patients seeking multiple applications over time, it should never be the first treatment you seek for hyperhidrosis. It’s crucial to be evaluated by your healthcare provider for excessive sweating as there could be other underlying conditions that deem Botox unnecessary, or in rare cases, unadvisable altogether.
How long does Botox work against sweating?
As you’ve probably guessed, Botox doesn’t last forever: Dr. Shipp indicates that prime effectiveness against uncontrollable sweating only lasts for about 90 days. And as muscles and nerves regenerate in the area, you’ll likely need another treatment within four to six months — over time, the region in question may need less treatment.
While uncontrollable excessive sweating can definitely be anxiety-inducing, health experts stress that sweating itself is an essential part of the body’s regulatory system; individuals could have as many as 2 to 4 million sweat glands across the body, per research. Botox isn’t intended to cease sweating forever by negatively impacting your sweat glands or ending your body’s ability to sweat in the first place. The injection is intended to quell overactive sweat glands over time instead.
Does Botox in your armpits hurt or cause other side effects?
According to treatment providers, there may be some pain to deal with when regularly receiving Botox treatments. We’re sharing a full list of potential risks of receiving Botox injections in your armpits below as published by Mayo Clinic experts — but both Dr. Shipp and Dr. Schwarz indicate that there are steps providers can take to prevent most of these irritating symptoms.
Potential risks of Botox injections include:
- Pain at the injection site
- Swelling or bruising on your body
- Headache and other flu-like symptoms
- Dry skin
You should immediately seek medical attention, within hours or weeks after your injection, if you notice:
- Uncharacteristic weakness in the implicated area
- Vision problems
- Respiratory issues, inability to speak, or trouble breathing
- Loss of bladder control
Botox may not be the cure-all for your own excessive sweating, however. Some patients may experience what’s known as a “rebound” sweating phenomenon, Dr. Shipp explains, which means that the sweating migrates to new trouble areas on your body. “An example is treating armpits for sweating, and it clears — but then the patient may experience excessive sweating on their lower backs or other places on the body,” he adds.
More often than not, though, advanced cases of hyperhidrosis will benefit greatly from Botox injections to areas where excess sweat is an issue. And patients most often enjoy safe treatments in appropriate clinical settings, Dr. Schwarz adds. If diagnostic sessions with your healthcare provider or a new dermatologist-approved deodorant don’t provide you real results, the injection may help to silently stem sweating and make your routine less daunting over time.
And while Botox has a reputation for being a pricey cosmetic option, all providers have come to recognize its ability to effectively treat hyperhidrosis, which is why many insurance plans work to make it accessible for all those who truly need it.
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