Using botox to curb excessive sweating can be an effective, but not permanent, solution.

Botox is a neurotoxin made from the microbes that cause botulism (a kind of food poisoning). It’s safe if used appropriately by a medical professional.

Botox is most well known as a cosmetic treatment to smooth facial wrinkles by temporarily paralyzing muscles. Doctors also use Botox to treat neuromuscular conditions like migraine, muscle spasms, and hyperhidrosis, a condition characterized by atypical and excessive sweating.

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.

Key Terms

“Off-label” 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 and safety for treating excessive sweating in other areas of the body.

Botox for sweating pros

Botox for sweating cons

  • expensive, with Botox for both underarms costing about $1,000 or more
  • considered painful if injected in the palms or soles of the feet
  • follow up injections are needed roughly every 7 to 16 months
  • only FDA-approved to treat armpits
  • pain and other side effects are possible, but generally mild

Botox injections block the release of the neurotransmitter acetylcholine, which binds with your sweat glands to signal the release of sweat.

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.

Currently, Botox has only been approved for the treatment of underarm sweating. Studies have found varying results, but there’s ample evidence that Botox can reduce armpit sweat production by more than 50% for at least 6 months.

Doctors use it “off-label” to treat other areas of the body.

  • Palms: A limited amount of research has investigated the effectiveness of Botox for palm sweating. Studies have found that Botox may reduce sweating by roughly 25% to 50% for 3 weeks to 6 months.
  • Face: Limited research has found that Botox may help treat facial sweating. One 2024 study found that injections significantly reduced facial sweating and improved quality of life over 1 year
  • Soles of feet: Botox may help control sweating on the soles of the feet, however few studies have been done and most focus on quality of life rather than measured results. In one 2024 study, the majority of participants “substantial” improvements to their quality of life. The researchers noted that more studies are needed.

Botox injections are a simple and quick procedure done right in a doctor’s office. Doctors typically ask that you wear a short-sleeved shirt and avoid shaving your armpits for 2 or 3 days prior to your appointment.

If you take blood thinners, your doctor may ask you to stop for a few days before 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.

Your doctor may also recommend wearing a dark-colored shirt to avoid getting ink on it.

Your appointment will likely last about 45 minutes but the injections will only take about 10 minutes.

Botox injections work best when given by an experienced practitioner. Injections don’t take long and can be completed during an office visit. A professional will mark your skin with ink, or apply the treatment area with a chemical solution of povidone-iodine and then cover it with a dusting of corn starch. After this mixture sits on the skin for a brief time, the white corn starch will change to purple or brown to show where the most sweating occurs.

The medical professional will then inject the Botox medication just below the surface of the skin using a fine needle. You’ll receive about 25 injections that form a grid pattern around your area of concern (such as a single armpit). Some clinics may give you slightly more or fewer.

The practitioner may give you something to prevent pain, like ice or a numbing agent.

You can return to work and day-to-day life as soon as you’re done with your Botox injections. The practitioner will likely ask you to schedule a follow-up appointment to check in and touch up any missed spots.

You can resume your normal activities immediately after receiving Botox injections. It usually takes between 2 and 4 days to notice your results and 2 weeks for the injections to take full effect.

The effects of Botox are temporary, which means you’ll need more injections in the future. For underarm sweating, booster injections are generally needed every 7 to 16 months. Results may not last as long for the hands and feet, and you may need to repeat your treatment after about 6 months. However, there’s still limited research examining the effectiveness of Botox for these body parts.

You should be able to go home immediately after your procedure. Generally, little aftercare is needed. You may feel tender around the treated area for the next day or so.

Your doctor will likely want you to follow up about 2 weeks after your appointment once the Botox takes full effect. You may need an additional procedure to treat any missed spots.

Doctors may recommend avoiding deodorant or products with perfume under your arms for up to a day to avoid irritation. Avoiding intense exercise and hot baths for a couple of days may also help.

The cost of Botox injections varies greatly depending on the area treated, the clinic you visit, and where you live. If you need several areas of your body done, the costs can be substantial.

The typical cost for both underarms can be about $1,000.

Some insurance companies cover all or part of the cost for people with hyperhidrosis. In most cases, your insurance company wants to see that you have tried other options first, such as prescription antiperspirants.

Many studies have been done evaluating the safety of Botox for underarm sweating. Most people tolerate this procedure well. Fewer studies have examined the safety of Botox when injected in other body parts to stop sweating.

Possible side effects may include:

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:

Botox is often an effective treatment for excessive sweating. For some people, it drastically improves their quality of life. The injections can be costly and aren’t always covered by insurance, but they may be a good option if you don’t respond to other treatments like prescription antiperspirants. You can speak with your doctor or insurance company about getting your Botox injections covered.