Hyperhidrosis treatment to reduce sweating

Using Botox® for Hyperhidrosis

Did you know that hyperhidrosis, or excessive sweating, can be treated with Botox® or Dysport®?  A recent study estimates that almost 5% of the United States population, or more than 15 million people, are living with hyperhidrosis.  Patients may not mention excessive sweating during their healthcare visits if they don’t realize it can be treated.  Usually, a topical aluminum antiperspirant is tried first.  This usually helps in the short term, but then loses effectiveness in the long term.  When topicals cannot control the sweating, patients may be interested in trying Botox® or Dysport® as their next treatment option.

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woman in t-shirt sweating under her arms

What should I expect during the treatment?

The skin will be cleansed with a chlorhexidine wash to decrease bacteria, and ice is used before and during the treatment to keep you comfortable.  Small dots of botulinum toxin type A are injected just below the skin to target the location of the sweat glands.  A grid pattern is followed, with about 1 injection per centimeter, so about 20-25 injections total per underarm or palm. 

Isn’t this painful?

Almost every patient finds the treatment very easy to tolerate with ice.  Also, the treatment is quick, with the actual injections only taking 10-15 minutes.

Does insurance cover this procedure?

No. However, if you have a flexible spending account or HSA, you will likely be allowed to use those funds for the procedure since hyperhidrosis is a medical condition.  You must have been previously diagnosed by a dermatologist or primary care physician with hyperhidrosis.  

How much does it cost?

We recommend starting with 1 vial of either Botox® or Dysport® to treat both underarms, or both palms of the hands.  The charge to inject 1 vial of either product is $800.  If you find that the effect does not last very long, or you are still producing too much sweat, then we can add additional units in half-vial increments for $350 per half-vial. 

How long does it last?

Results are reported to last 4-12 months.  How long your effect lasts depends on how severe your sweating is and how much botulinum toxin is injected.  Larger doses will create a longer lasting effect.

Are there any side effects?

Pinpoint bleeding at the injection sites and small bruises are possible.  Infection is unlikely, but possible, so you should keep the area clean and dry for 24 hours after injection. 


Doolittle, J., Walker, P., Mills, T., & Thurston, J. (2016). Hyperhidrosis: an update on prevalence and severity in the United States. Archives of dermatological research, 308(10), 743-749.