Botox injections are used to treat a variety of medical conditions. Botox is a neurotoxin made from the microbes that cause botulism (a kind of food poisoning). But don’t worry, it’s very safe if used appropriately by a medical professional. Botox got its start as a cosmetic treatment. It smooths facial wrinkles by temporarily paralyzing muscles. Doctors also use Botox to treat neuromuscular conditions such as migraines, muscle spasms, and hyperhidrosis. Hyperhidrosis is the medical term for excessive sweating. It refers to any abnormal sweating, such as sweating when it’s not hot. People who sweat excessively often soak through their clothing or drip sweat. Regular antiperspirants don’t work well for those with this condition.

Botox injections are a new treatment option for people with hyperhidrosis. You may be a candidate for Botox if your sweating fails to improve with prescription antiperspirants. Botox has been FDA-approved for people who sweat excessively from their armpits. It may also be used “off-label” to reduce sweating in other areas, such as the hands, feet, and face.

Off-label use refers to using a medication for something other than what it was approved to treat. In this case, it means that Botox hasn’t gone through the same amount of rigorous testing to confirm its effectiveness for treating excessive sweating in other areas of the body.

How do Botox injections work?

Botox works by blocking the nerves responsible for activating your sweat glands. Normally, your nervous system activates your sweat glands when your body temperature rises. This is how your body automatically cools itself. In people with hyperhidrosis, however, the nerves that signal the sweat glands are overactive.

When you receive Botox injections directly into the area of your body that commonly sweats, your overactive nerves are essentially paralyzed. When your nerves can’t signal your sweat glands, you don’t sweat. However, Botox only prevents sweating in the specific area where it’s injected.

Where is Botox used?

Currently, Botox has only been approved for the treatment of underarm sweating. In studies, Botox was extremely effective in treating underarm sweating. Doctors use it “off-label” to treat other areas of the body.

Studies have found that Botox successfully treats sweaty palms in 80 to 90 percent of cases. However, the treatments don’t last quite as long as the underarm treatments. Studies also show that Botox works to treat forehead sweat. It can reduce sweating by 75 percent for about five months.

Researchers believe that Botox could help with sweating on the soles of the feet, however few studies have been done. Of particular concern is that injections in the feet are considerably more painful than other areas.

What’s it like to get Botox injections?

Botox injections work best when given by an experienced practitioner. Injections don’t take long and can be completed during an office visit. Your doctor will inject the Botox medication just below the surface of the skin using a fine needle. You’ll receive several injections that form a grid pattern around your area of concern. Your doctor may give you something to prevent pain, like ice or a numbing agent.

You can return to work and normal life as soon as you’re done with your Botox injections. Your doctor may ask you to schedule a follow-up appointment to check in and touch up any missed spots.

How do I prepare for the procedure?

Botox injections are a simple and quick procedure done right in your doctor’s office. Doctors typically ask that you avoid shaving your armpits for two or three days prior to your appointment. If you take blood thinners, your doctor may ask you to stop for a few days prior to your injections to prevent bruising. Tell your doctor about any medications you’re taking and don’t stop taking any medications unless your doctor tells you to.

How much does it cost?

The cost of Botox injections varies greatly depending on your circumstances and where you live. If you need several areas of your body done, the costs can be substantial. The typical cost for two underarms is roughly $1,000. Fortunately, many insurance companies cover all or part of the cost. In most cases, your insurance company wants to see that you have tried other options first, such as prescription antiperspirants.

What are the risks and side effects?

Many studies have been done evaluating the safety of Botox. Most people tolerate it well. Possible side effects include:

  • pain or bruising at the injection site
  • headache
  • flu-like symptoms
  • droopy eyelid (for facial injections)
  • eye dryness or tearing (for facial injections)

Serious side effects of Botox injections are extremely rare. Serious side effects happen when the Botox affects your entire body. This can happen hours, days, or weeks after your injections. Rare but serious side effects include:

  • muscle weakness in the entire body
  • trouble seeing
  • difficulty breathing
  • loss of bladder control
What to expect after treatment

You can resume your normal activities immediately after receiving Botox injections. It will take between two and seven days for you to stop sweating in the treated area. It can take two weeks for total dryness.

The effects of Botox are temporary, which means you’ll need more injections in the future. For underarm sweating, dryness can last anywhere from four to fourteen months. Results may not last as long for the hands and feet, and you may need to repeat your treatment in about six months.

About two weeks after your treatment, once you have seen the full effects of the Botox, you should see your doctor for a follow-up appointment. At this appointment your doctor can perform any “touch ups” of missed spots.

Bottom line

Botox is a highly effective treatment for excessive sweating. For many people, it drastically improves their quality of life. Unfortunately, the injections can be costly and aren’t always covered by insurance. You can talk to your doctor or insurance company about getting your Botox injections covered.