Excessive Underarm Sweating


Primary axillary hyperhidrosis (excessive sweating of the underarms) is a condition that a person is unable to obtain relief using antiperspirants.

Botulinum toxin A (BOTOX) is a natural, purified protein with the ability to temporarily block the secretion of the chemical that is responsible for "turning on" the body's sweat glands. By blocking, or interrupting, this chemical messenger, botulinum toxin "turns off" sweating at the area where it has been injected. Botox injections are very shallow, meaning that the medicine is injected just below the surface of the skin, where it remains.

 Over the years Botox has been used to treat millions of patients with various conditions, including spasticity and movement disorders. At least 20 countries have approved Botox for the treatment of underarm excessive sweating.

Botox may result in an 82-87% decrease in sweating when it is used to treat underarm excessive sweating.  The effect of Botox starts approximately 2 to 4 days after treatment with the full effects usually noted within 2 weeks. Dryness typically lasts 4 to 12 months but some studies have found it can last as long as 14 months.


What does the procedure entail?

Multiple superficial injections using small insulin syringes with minimal pain and discomfort.

Pre-treatment care:

  • Shave underarms the day before treatment
  • Take a shower in the morning
  • Do not use antiperspirant after taking a shower

Post-treatment care:

  • The person can resume daily living activities after the procedure
  • Avoid touching, rubbing or massaging the area for 24 hours
  • Avid alcohol and exercise the same
  • Avoid hot sauna and sunbathing for two weeks


  • Pregnancy
  • Breastfeeding
  • Myasthenia gravis
  • eaton lambert syndrome


The consensus statements and an evidence-based review identified three large randomized, placebo-controlled trials, involving 672 subjects, of the efficacy and safety of botulinum toxin in the treatment of primary axillary hyperhidrosis [Hornberger et al, 2004; DTB, 2005; Solish et al, 2007].

 Another large, randomized, placebo-controlled trial, involving 322 subjects and lasting 1 year, has since been published [Lowe et al, 2007]. Each study reported statistically significant improvements in symptoms with Botulinum toxin compared with placebo.

 Published research studies have shown that repeated treatment with Botox is safe and effective for hyperhidrosis and consistently results in meaningful, long-lasting improvements in an excessive sweating patient’s symptoms, daily functioning, and quality of life.

Research demonstrates that treating excessive sweating of the armpits, hands, feet, head and face (craniofacial), and other relatively small body areas (like under the breasts) with Botulinum Toxin A is safe and effective.