Botox is a treatment that involves injecting a toxin into the skin. It has both medical and cosmetic uses, and some people find it effective in reducing excessive sweating, such as in the underarm area.

This article discusses the safety and effectiveness of Botox injections to treat excessive sweating. We also outline the treatment procedure, and provide tips for preparation and aftercare.

A person with very sweaty armpits, who may be considering botox for sweating.Share on Pinterest
People who sweat excessively may consider Botox as a way to reduce underarm sweating.

The United States Food and Drug Administration (FDA) have approved Botox injections to treat excessive underarm sweating. It works by blocking a chemical in the body that activates the sweat glands.

According to the International Hyperhidrosis Society, underarm Botox injections can reduce underarm sweating by 82–87%. The effects can typically last 4–12 months, or up to 14 months in some cases.

People who receive underarm Botox injections tend to see results 2–4 days after treatment. The full effects are usually noticeable within 2 weeks.

However, Botox is not a permanent solution for excessive underarm sweating. A single treatment lasts around 4–12 months, so a person needs ongoing injections.

To date, the FDA have approved Botox injections for underarm use only. However, a doctor may prescribe the treatment for excessive sweating elsewhere on the body, such as the hands, feet, head, or face.

Botulinum toxin is a neurotoxin made by the bacteria Clostridium botulinum. Neurotoxins are substances that affect the structure or function of the nervous system.

Botox alters the function of certain neurotransmitters. These are chemicals in the body that instruct the body to react in a certain way. Botox blocks the neurotransmitter that tells the sweat glands to activate, to control sweating in the injection area.

Botox injections can be expensive. An approximate cost for both underarms is $1,000, and a person needs to repeat the treatment every 7–16 months, so the expenses can add up.

Health insurance providers may cover the cost of Botox for excessive sweating. However, some may do so if a person can show other treatments do not work.

Doctors may prescribe Botox to treat excessive sweating on other areas of the body prone to excessive sweating. These include:

  • hands
  • feet
  • back
  • chest and under the breasts
  • groin
  • head
  • face
  • nose

Botox treatments in the hands or feet tend to be less effective, and are more likely to cause side effects. The procedure can also be more painful in these areas.

Some experienced dermatologists can also use Botox to treat sweating of the face, groin, or breasts. Those who inject these areas need detailed knowledge of the complex muscles and tissues for safe and effective treatment.

A person who wishes to have Botox injections to treat excessive sweating should find a certified medical professional with the appropriate experience.

The International Hyperhidrosis Society provide a database of physicians who specialize in treating excessive sweating.

A dermatologist, or a doctor certified to use Botox, can perform the injections in their office. Experienced medical professionals can inject both underarms in 10 minutes or less.

For the procedure, a medical professional injects very small amounts of Botox beneath the skin. They usually inject it in a grid pattern, with injection sites approximately 1–2 centimeters apart.

Before they inject the skin, the doctor may numb the area with ice or a local anesthetic. This will help to ease any pain or discomfort.

Below are some tips around what to do before and after treatment.

Before the procedure

Prior to the procedure, a person will consult with their doctor. They should take this opportunity to tell the doctor about any medical conditions they have, and medications they currently take. This can help reduce the risk of side effects and complications.

People who undergo Botox injections should not shave their underarms for 3–4 days before the treatment.

After the treatment

A person can go home immediately after Botox treatment. They should avoid exercise, and not have hot baths or showers for the rest of the day.

Most healthcare providers will recommend a follow-up appointment 1–2 weeks after the procedure. This is to touch up any missed areas, and check for side effects.

Side effects

Botox injections are generally safe. Serious side effects are rare, but possible. They include:

A person who has any of the following side effects after Botox should seek immediate medical attention:

Less severe side effects may include:

Like all treatments for excessive sweating, Botox has various pros and cons. Some examples of each are outlined below.


  • effective
  • relatively long-lasting
  • relatively painless
  • less invasive than surgery


  • expensive
  • not permanent
  • potential side effects
  • not suitable for all areas of the body

A person who experiences excessive sweating can talk to their doctor for advice on the most effective treatment.

Other potential uses for Botox include:

  • Muscle disorders: Botox can help relax clenched muscles and control overactive muscle movements, such as muscle twitches.
  • Chronic migraine: Botox can help prevent chronic migraines in some people.
  • Facial wrinkles: Some dermatologists provide Botox injections to reduce the appearance of lines and wrinkles on the face.

Hyperhidrosis is the medical term for excessive sweating caused by overactive sweat glands.

There are two types of hyperhidrosis: primary focal hyperhidrosis, and secondary generalized hyperhidrosis.

Primary focal hyperhidrosis

Primary focal hyperhidrosis (PFH) is excessive sweating not caused by another medical condition, or a side effect of medication.

A person with PFH typically experiences symmetrical sweating on specific areas of the body. For example, they may experience excessive sweating of both hands or feet.

In PFH, excessive sweating occurs at least once a week.

Secondary generalized hyperhidrosis

Secondary generalized hyperhidrosis (SGH) is when a medical condition or side effect of medication causes excessive sweating.

People with SGH tend to sweat across large sections of their body. They may also sweat while sleeping.

A person with SGH symptoms should see a doctor to determine the cause.

In some cases, it may be possible to control sweating with a strong antiperspirant. A person can ask a pharmacist for advice on the best products to use.

Sometimes, over-the-counter treatments may not be effective. People should see a doctor if they experience:

  • symptoms of SGH
  • excessive sweating around the groin or feet, which can lead to bacterial or fungal infections
  • embarrassment, and avoidance of activities that may increase sweating, such as physical activity or going out in hot weather

Botox injections can be an effective way to control excessive sweating. The FDA have approved this treatment for underarm use only. However, a doctor may prescribe the injections to control excessive sweating in other areas of the body.

Botox is relatively costly compared with other treatments for excessive sweating. Since each treatment lasts 4–12 months, the costs add up over time. Some health insurance providers can cover the expense, but only if other treatments are not successful.

Excessive sweating can sometimes indicate an underlying medical condition, or a side effect from a medication. A person should see a doctor if they have concerns about excessive sweating.