Harwer M.D. Partners in Health

BOTOX® Treatment of Hyperhidrosis

Excessive Sweating - Hyperhidrosis

What is Hyperhidrosis?

Hyperhidrosis, a medical condition involving overactive sweat glands, is a common disosrder that causes a lot of unhapiness. Its main symptoms include excessively sweaty palms, hands, armpits or feet, and facial blushing. Extreme underarm sweating (Primary Axillary Hyperhidrosis) is the most socially embarrassing condition because of highly visible wet spots and stained clothes. Sweat is the body's temperature regulator, and in primary Hyperhidrosis sweating significantly exceeds the body's normal cooling requirements. This excess sweat causes their armpits to be constantly moist and damp. Underarm wet spots are not only embarrassing, but they also stains clothes, complicate business and social interactions, and make everyday activities a lot more difficult to carry out. Contrary to popular belief Hyperhydrosis does not cause body odor. The smell that many believe is due to sweating is in fact caused by bacterium that grows on the skin if the wet sweat is present. How long it takes for the odor to appear depends on the environment and varies considerably from person to person.

An estimated 2% to 3% of Americans suffer from excessive sweating of the underarms (axillary Hyperhidrosis) or of the palms and soles of the feet (palmoplantar Hyperhidrosis). Underarm problems tend to start around puberty, while palm and sole sweating may begin earlier, often during childhood. If left untreated these problems may continue throughout life, but fortunately majority of these symptoms can now be successfully treated.

classic location of hyperhidrosis

BOTOX® treatment of excessive sweating (Hyperhidrosis)

Main BOTOX® treatment areas:

What causes Hyperhidrosis?

Primary Axillary Hyperhidrosis is caused by overly active sweat glands. Sweat production in patients with PAH greatly exceeds the body's normal cooling requirements. PAH patient's armpits are constantly wet, making everyday activities more difficult to carry out. Hyperhidrosis itself does not cause a body odor, which is caused by the bacteria on the skin that grows if sweat remains on the skin. Though neurologic, metabolic, and other systemic diseases can sometimes cause excessive sweating, most cases occur in otherwise healthy patients. Heat and emotions also trigger Hyperhidrosis in some people, but most people suffering from Hyperhidrosis sweat nearly all the time, regardless of their mood or the weather.

What can I do about Hyperhydrosis?

Always wear clothes that keep you cool. Avoid stress, tension and anxiety which are extra difficult problems for Hyperhidrosis patients. Prevent unpleasant odor by maintaining impeccable personal hygiene, including frequently changing yout socks and clothes, taking frequent showers, repeated hand washing, etc.

BOTOX® treatments for Hyperhidrosis

In addition to cosmetic treatment for wrinkles, BOTOX® (botulinum toxin) has been approved in the U.S. by the FDA for the treatment of excessive underarm sweating. BOTOX® has also been used in many areas of medicine for some time, including treatment of muscle spasms and certain types of headaches. Fifty (50) BOTOX® units are injected into approximately twenty spots in each armpit. This may produce approximately six months of relief from sweating. While injections are uncomfortable, the use of very small injection needles and use of skin numbing creams minimizes any discomfort. The FDA has not yet approved Botox for treatment of sweating of the palms and soles of the feet, though many physicians have used BOTOX® off-label with good results. Drawbacks of using this treatment for the palms and soles are the pain and the potential of side effects including temporary muscle weakness

How Does BOTOX® Work?

How does BOTOX® work?

When the BOTOX® (a neurotoxin approved for the treatment of Hyperhidrosis) is injected into the armpits, it reduces or stops the sweat production by temporarily blocking the chemical signals from the nerves that stimulate and control the function of these glands. When the sweat glands don't receive these chemical signals the severe sweating stops for a period of time. While the effects of the treatment last for several months, they will gradually wear off in time a repeated treatment is required.

How is BOTOX® applied?

Using an ultra fine needle physician carefully injects small doses of BOTOX® solution in twelve to fifteen specific places spread evenly about 1 cm apart in each armpit. Iodine and starch method is used to reveal the areas with the greatest sweating to precisely position the injections

How fast does BOTOX® work?

You will notice improvement within the first week after your treatment, while the full effect will take between two and three weeks.

How effectively does BOTOX® reduce sweating?

Each person responds differently to BOTOX® treatment. Recent clinical trials showed that one week after treatment the average sweat reduction was about 87% and sweating was significantly reduced in 95% of patients.

How safe is BOTOX® treatment?

BOTOX® is approved in more than 80 countries worldwide and has been used therapeutically for 20 years to treat a variety of medical conditions. BOTOX® is approved by the FDA to treat the symptoms of severe Hyperhidrosis (underarm sweating) when topical medicines do not produce sufficient results. BOTOX® is also one of the most widely researched medicines in the world. Dosing specific to treatment of excessive underarm sweating was approved as safe by the FDA.

What if I stop BOTOX® treatments?

BOTOX® effects usually last for several months. If you the treatments you can expect no permanent changes in the treated areas, and sweating will gradually return to the level before the treatment. Most of our patients come for anjual treatments and are very happy for up to twelve months.

What happens to excessive sweat after BOTOX® treatment?

Patients requiring BOTOX® for treatment of overactive underarm sweat glands can also be experiencing excessive sweat on their feet, hands, face or genital area. BOTOX® neurotoxin injections temporarily stops sweat production solely in the treated areas. Sweat continues to be produced elsewhere and your body's health is unaffected by treatment. BOTOX® treatment only affects the treated areas and it's effects are completely reversed within a few months.

Patient Preparation:

BOTOX® patients success stories

Here is what some of our patients treated with BOTOX® say:

"My sweating is under control, and don't have to change shirts several times a day."

-Jonathan M.

"I don't think about what to wear or if I have enough clothes to cover up."

-Patricia K.

"Sweating is not something that's controlling my daily routine anymore. Now I can do things like standing up in front of a group of people at work without having to look down to see if I'm sweating under my arms. Thankfully, BOTOX® treatments have helped me control my underarm sweating."

-Simona R.

"I used to spend $120 each month replacing ruined clothes, dry cleaning my stained clothes and buying anti-perspirants that didn't control my sweating. Now it's under control and I am saving all that money."

-Denise L.

"I wouldn't go out with my friends because I was worried I will sweat and stink. Now all the sweating is gone and I can't wait to go out every week."

-Frank T.

Does Botox® have side effects?

You can find a list of BOTOX® side effects listed below or by visiting: WebMD: BOTOX®

The following side effects are associated with Botox®:

IMPORTANT NOTE: Dr. Harwer has been using Botox for 20 years and we never had a single patient with Botox complications listed below. However, small pinpoint bruising immediately after the treatment is quite common.

Common side effects of Botox® Cosmetic IM:

Poor Eyelid Closure


Drying and Inflammation of Cornea and Conjunctiva of Eyes


Sensitive to Light

Less Severe

Drooping of the Upper Eyelid

Less Severe

Excessive Watery Eyes

Less Severe

Deviation of the Eyes Upward or Downward

Less Severe

Eye Irritation

Less Severe

Hemorrhage of Blood Under the Skin

Less Severe

Signs and Symptoms at Injection Site

Less Severe

Infrequent side effects of Botox® Cosmetic IM:

Double Vision






Problems with Eyesight

Less Severe

Accumulation of Fluid in the Tissues of the Eyelid

Less Severe

Throat Irritation

Less Severe


Less Severe

Neck Pain

Less Severe


Less Severe

Flu-Like Symptoms

Less Severe


Less Severe

Head Pain

Less Severe


Less Severe

Rare side effects of Botox Cosmetic IM

Inflammation of the Cornea of the Eye


Food Poisoning due to improperly canned or preserved food


Eyelid is Turned In


Eyelid is Turned Out


Infrequent Blinking of the Eyelids


Infection of Lung from Inhaling Stomach Contents


Adult Respiratory Distress Syndrome


Muscle Weakness


Voice Disorder


Difficulty Speaking


Trouble Breathing


Difficulty Swallowing


Problems with Bladder Control


Collection of Clotted Blood in an Organ, Space or Tissue


Chest Pain

Less Severe

Not Feeling Well

Less Severe


BOTOX® is the answer to many problems - but only in the skilled hands!

To learn more about BOTOX® visit: Allergan.com - BOTOX®

You can find more information about Hyperhidrosis at: SweatHelp.com



Will Insurance Cover BOTOX® Treatment?

Some medically related BOTOX® treatments are usually covered by insurance, including treatment for blepharospasm (uncontrollable eye twitching), excessive sweating, constant pain and others. Insurance coverage for BOTOX® Cosmetic injections is much less common, but you should consult your insurance provider to find out if you have coverage for BOTOX® treatment. Call Allergan BOTOX® reimbursement hotline at 1-800-530-6680 and ask Allergan representative to help you determine whether your procedure is covered by insurance.