Botox for Sweating (Hyperhydrosis)

EXCESSIVE UNDERARM SWEATING AND BOTOX™!

Nobody really wants to talk about “sweaty armpits.”  It’s socially embarrassing and it ruins your clothing.  Antiperspirants are a billion dollar industry so you are not alone in being concerned about this malady. But when is normal underarm sweating, or perspiration, excessive and how do you know if you should see the dermatologist about this condition?  Read on!

The armpit, or “axillae” as it is medically known contains skin that is loaded with sweat glands.  That’s why it is this area that tends to sweat more than other areas.  But even other areas, like the hands and feet may be involved in excessive sweating.  These sweat glands are under the influence of nerves.

When is a sweating armpit more than just a non-consequential finding?  If you find yourself worried about the amount of sweating you do, that is a sign of a problem.  If you are embarrassed or self-conscious when you raise your hand, that is a sign of a problem.  If you are ruining clothing from sweating, that is a sign of a problem.  If you find yourself putting layer upon layer of cotton or clothing under your armpits, then probably your antiperspirant is unable to keep up with the amount of sweat you produce.

Is there any good news to this story?  You bet there is! Because the sweat glands are under the influence of nerves, your dermatologist can use Botox™ Cosmetic injections into the area and you will probably be amazed at how wonderfully this technique works!  It’s not permanent, but it can be repeated from time to time (maybe 2 or three times per year, that’s all) and even the most wet of armpits will usually dry out nicely.

Technique

Here’s how it’s done:  The hair does not have to be shaved (for you men), but it does make it easier to at least cut the hair short.  The area is daubed with an iodine solution, which dries, and then cornstarch is applied.  The area where sweating occurs will “light up” and the dermatologist will then know where to place the tiny injections. Usually, the dermatologist will mark the armpit with random “dots” indicating where the injections will go. There are a number of small injections, about 12-15 per side, but they are very easy to tolerate…and for the timid, we can apply an anesthetic cream beforehand.  The dosage is 50 units of Botox™ per side, which will consume the entire vial of Botox™.  Most of the time, the charge is a certain amount “per unit” so knowing the amount of units is important.

Within a short time (perhaps a week), you will notice the change and will probably no longer need any antiperspirant although you may want to use a deodorant. Sometimes, there will continue to be some areas of sweating.  If this occurs, you go back to the dermatologist and will once again get painted with the iodine and cornstarch, and any remaining problem areas will get a few units (2-5 units) more. And that’s all there is to it: one of the miracles of modern science, if you ask me!

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