Dr. Joseph M. Perlman Advanced Plastic Surgery Centre


Botulinum toxin is a drug used to temporarily block muscles and is employed in the treatment of certain muscle conditions, reduction of wrinkles, and control of excessive sweating. It has gained widespread recognition as an effective treatment for axillary hyperhidrosis.



Botulinum toxin is a drug that temporarily blocks muscles to treat certain muscle conditions, reduce wrinkles or stop sweat. This treatment has become a widely recognized treatment for axillary hyperhidrosis.

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Botox injections have proven to be effective in treating various medical conditions. Derived from the microbes responsible for botulism (a type of food poisoning), Botox is a neurotoxin. However, when administered by a medical professional appropriately, it is considered safe.

Initially, Botox was primarily used as a cosmetic treatment to reduce facial wrinkles by temporarily paralyzing muscles. Nowadays, it is also utilized to address neuromuscular conditions like migraines, muscle spasms, and hyperhidrosis.

FDA-Approved for Treating Hyperhidrosis

In 2004, the U.S. Food & Drug Administration (FDA) granted approval for BOTOX (onabotulinumtoxinA) as a treatment for severe primary axillary hyperhidrosis, which refers to excessive sweating of the underarms in patients who do not find relief with antiperspirants. Developed by Allergan, Inc., located in Irvine, California, BOTOX is one of the most extensively studied brands of botulinum toxin worldwide. It received its initial FDA approval in 1989 and is now approved to treat a total of eight medical conditions in the United States.

Over the years, BOTOX has been employed to treat millions of patients with various conditions, including spasticity and movement disorders. It has also been approved for the treatment of underarm excessive sweating in at least 20 countries.

What Does Research Say?

Research has provided evidence that onabotulinumtoxinA (Botox) is a safe and effective treatment for excessive sweating (hyperhidrosis) in various body areas such as the armpits, hands, feet, head and face (craniofacial), and under the breasts. When used for underarm excessive sweating, Botox has been observed to reduce sweating by 82-87%.

The results of the treatment typically become noticeable within 2 to 4 days after the procedure, with the full effects manifesting within 2 weeks. The dryness achieved through Botox injections usually lasts between 4 to 12 months, although some studies have indicated it can persist for up to 14 months. Multiple published research studies have consistently shown that repeated Botox treatments for hyperhidrosis are safe and effective, leading to significant and long-lasting improvements in patients’ symptoms, daily functioning, and quality of life.

Understanding Sweating

Sweat plays a crucial role in human survival as it acts as the body’s natural coolant, preventing overheating.

Our bodies contain two to four million sweat glands, with the majority being “eccrine” sweat glands. These eccrine glands are abundant on the soles of the feet, the palms, the forehead and cheeks, and in the armpits. They secrete a clear and odorless fluid that aids in temperature regulation by promoting heat loss through evaporation. In cases of hyperhidrosis, the type of sweat involved is typically eccrine sweat.

The other type of sweat gland is known as the “apocrine” gland, which is primarily located in the armpits and genital region. These glands produce a thicker fluid that, when combined with bacteria on the skin’s surface, results in the characteristic and potent “body odor.”

What Are The Stimuli?

The activation of both eccrine and apocrine sweat glands is controlled by nerves, which respond to various stimuli, including signals from the brain indicating elevated body temperature, hormones, emotions, and physical activity or exercise.

In individuals with hyperhidrosis, especially affecting eccrine glands, these sweat glands become overactive and excessively responsive to stimuli, leading to the production of more sweat than necessary. This condition is often characterized by sweat glands that remain in a state of hyperactivity or being “stuck in the on position.”

Contrary to a popular misconception found on the internet, sweat does not consist of toxins, and sweating does not serve as a means to “sweat out” toxins. In reality, sweat primarily comprises 99 percent water, along with small amounts of carbohydrates, salt, protein, and urea. The process of detoxifying the body is primarily performed by the kidneys and liver, not the sweat glands.

How do Botox injections work?

Botox works by blocking the nerves that stimulate the sweat glands, effectively preventing excessive sweating in the treated area. When you receive Botox injections for hyperhidrosis, the overactive nerves responsible for signaling the sweat glands are temporarily paralyzed. As a result, the sweat glands in the treated area do not receive the signals to produce sweat, and sweating is significantly reduced or eliminated.

It’s important to note that Botox is a localized treatment, and its effects are limited to the specific area where it is injected. If you receive Botox injections for underarm hyperhidrosis, for example, it will only prevent sweating in the underarm region. Other areas of your body will not be affected by the Botox treatment and will continue to sweat normally.

Botox is a safe and effective treatment for hyperhidrosis, and its effects typically last for several months before gradually wearing off. It can significantly improve the quality of life for individuals who suffer from excessive sweating in specific areas of the body.

Where is Botox used?

Currently, Botox has only been officially approved for the treatment of underarm sweating. However, doctors may use it “off-label” to treat other areas of the body affected by excessive sweating. Studies have shown that Botox is highly effective in treating sweaty palms, with success rates ranging from 80 to 90 percent. The effects of Botox on sweaty palms may not last as long as underarm treatments.

Botox has also been found to be effective in treating forehead sweat, reducing sweating by approximately 75 percent for about five months. There is potential for Botox to help with sweating on the soles of the feet, but limited research has been conducted in this area. It’s worth noting that injections in the feet can be more painful compared to other areas, which raises concerns about its feasibility for this application. Further research is needed to fully explore the potential of Botox in treating excessive sweating in different areas of the body.

Take The Next Step!

Have you discussed your excessive sweating with a medical professional? If not, it’s a good idea to do so now! Consider scheduling a free consultation with Dr. Perlman in Houston to explore the option of using BOTOX to address your excessive sweating.

Botox has proven to be highly effective in treating excessive sweating for many individuals, significantly improving their quality of life. Keep in mind that Botox injections can be expensive and may not always be covered by insurance. To explore potential coverage options, you can discuss this with Dr. Perlman or reach out to your insurance company for more information.

Must Know About BOTOX for Excessive Sweating

What to expect after treatment

After receiving Botox injections, you can resume your regular activities without delay. The effects of the treatment will gradually take effect, with sweating in the treated area expected to subside between two to seven days. Full dryness is typically achieved within two weeks.

How long does it last?

Botox’s effects are not permanent, and subsequent injections will be necessary in the future. For underarm sweating, dryness can persist for approximately four to fourteen months. However, results may not endure as long for the hands and feet, requiring another treatment session in about six months.

Getting touch-ups

Approximately two weeks after your Botox treatment, when the full effects become visible, it is advisable to schedule a follow-up appointment with your doctor. During this visit, your doctor can address any missed spots and perform any necessary touch-ups.

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We are excited to assist you in achieving a dry and comfortable experience! Begin your journey by reserving a complimentary consultation online with Advanced Plastic Surgery Centre to get started with your treatment.