Botox for Axillary Hyperhidrosis

What causes underarm sweating?

Hyperhidrosis is the medical term for excessive sweating, and when it occurs in the underarm skin it is called “axillary hyperhidrosis.” This is caused by stimulation of the eccine sweat glands (pronounced ek’-krine) by the nerve endings which are the final nerve pathways from higher centers in the brain. These nerves respond to different kinds of stress: emotional stress like intimate social situations or public speaking, or physical stress like the increased body temperature that comes with exercise or hot and humid weather.

Some people are plagued with excessive sweating on a round-the – clock basis. Other people are bothered only when they are under emotional stress, physically active, or over-heated. In either case, Botox ® Purified Neurotoxin Complex* may be the answer. The nerves that control sweating depend upon a chemical transmitter called acetylcholine which is a molecule produced at the very ends of the nerve fibers. Botox® is a genetically engineered neurotoxin which can, when injected into the skin, block the release of the acetylcholine to the sweat glands for months!


What are the alternative treatments?

Deodorants & Anti-perspirants
Topical antiperspirant sticks, creams, lotions and solutions typically use aluminum chloride hexahydrate salts which “pickle” the skin and prevent the sweat from exiting the pores of the skin. They are highly irritating with continued use and largely ineffective for people with excessive sweating.

Anti-cholingeric drugs & tranquilizers
Medications currently used cause dry mouth, blurred vision and minimally reduce sweating. Tranquilizers may minimize your anxiety over sweating, but rarely diminish the flood.

Tap Water Iontophoresis
Various battery powered electrical devices have been used over the years which use a tap water moistened pad and electrical current held against the axillary skin for several hours. This decreases the sweating but is very time consuming, needs to be repeated on a daily or weekly basis and is only mildly effective for severe cases.

Surgeons have often resorted to cutting out all the skin of the underarms, trading very visible scars and permanent numbness of the skin for a decrease in sweating. Neurosurgeons use a fiberoptic surgical tube inserted into the neck to cut the nerve fibers leading to the axillary sweat glands and arms (endoscopic sympathectomy). This approach involves the risk of anesthesia, and possible nerve damage to structures in the neck which can result in paralysis, loss of sensation and even permanent dilation of the pupil of the eye as a reflex injury. Cosmetic surgeons and dermatologists have attempted to scrape the underside of the axillary skin with liposuction cannulae to remove the sweat glands. Results have been mixed.


How is BOTOX® given?

A very small needle is used to inject small drops of Botox ® into the hair-bearing skin of the underarms in approximately 12 to 15 places on each underarm. Heavy physical exercise should be avoided for several hours, but patients may engage in any normal activity.


When will BOTOX® take effect?

Most patients will obtain 5-6 months of dryness with one treatment of Botox®.


How long does BOTOX® last?

Your underarm sweating will decrease to 95% within 48 hours and the full effect will be seen within 1 week. Along with the sweating, there is a simultaneous disappearance of odor associated with the decreased sweating.


What are the risks and complications?

The only complications from injection into the axillary skin are: 1) tiny bruises are occasionally seen which fade in a few days; and 2) occasionally small persistent areas of sweating that may need a second treatment session. There is no risk of muscle weakness, numbness or permanent change in the axillary skin.


Who are good candidates for “No Sweat” Botox®?

People with problem underarm sweating; People working close to others such as hairstylists, nurses, dentists and hygienists; People working in close quarters such as flight attendants, pilots and surgeons; People working in hot conditions such as models, television newscasters and chefs; People making public presentations such as executives, attorneys and salesmen; and people who have ruined their clothes on special occasions such as weddings.

“No Sweat” BOTOX® for Hyperhidrosis¬†

If you are interested in learning more about “No Sweat” Botox®, please email us or contact our office for an appointment. Any and all references herein to ‘Botox®‘ refer to ‘Botox® Purified Neurotoxin Complex’, which is a registered trademark of Allergan *Botox® Purified Neurotoxin Complex is an FDA approved medication for various kinds of muscle spasm and spastic rigidity, but has not been specifically approved for the treatment of hyperhidrosis. The FDA recognizes the common practice among physicians to use FDA approved drugs in so-called “off label” uses, particularly in diseases and conditions for which there are lesser alternatives. Botox® Purified Neurotoxin Complex is a registered trademark of Allergan Herbert Laboratories, In