Botox for Excessive Sweating
Hyperhidrosis is sweating far beyond what your body needs to stay cool, and it does not care how strong your antiperspirant is. Botox, FDA-approved for underarm sweating since 2004, quiets the nerve signals that drive the sweat glands. One 30 to 45 minute visit can keep underarms dry for six to twelve months.
How Botox stopsexcessive sweating
Sweat glands are switched on by acetylcholine, a chemical signal sent from nearby nerves. In hyperhidrosis the sweat glands are overactive, producing more sweat than the body needs to regulate its temperature. Botox injected into the skin, not the muscle, temporarily blocks those signals, so the glands stop overproducing sweat and normal moisture regulation is restored.
Hyperhidrosis comes in two forms: primary, which is localized and has no known cause, and secondary, which stems from another condition or a medication. Your visit starts with a consultation, sometimes including a starch iodine test that maps exactly where the overactive zones are. The injections themselves are done with a fine needle and the whole appointment takes 30 to 45 minutes, after which you return to your day immediately.
Results appear within two to seven days and reach full effect around two weeks. Underarm dryness often lasts six to twelve months; palms and feet typically stay dry four to six months. And when treatment is medically necessary, insurance may cover it. Our office assists with the pre-authorization and documentation.
Who is this treatment for?
Botox is for people whose sweating runs their schedule: the shirt changes, the avoided handshakes, the ruined shoes.
Botox for sweating is not recommended during pregnancy or breastfeeding, or with certain neuromuscular conditions. Your medical history is reviewed at the consultation.
Antiperspirants have failed
You sweat excessively despite clinical-strength antiperspirants.
It affects your social life
You avoid handshakes, raised arms, or social situations because of sweat.
It is costing you things
Clothing, shoes, even electronics ruined by moisture.
You want a lasting, non-invasive fix
No incisions and no downtime, with results measured in months, not days.
Where itworks
Underarm treatment is FDA-approved; palms, soles, and the face are treated off-label with excellent results. Less common areas such as the back, groin, or chest can also be treated.
Select an area on the figure to see what to expect there.
See it at our office
Watch how we treat hyperhidrosis at our Montgomery Road office, and hear a patient describe what life is like once the sweating stops.
If this sounds familiar, a consultation covers your areas, your dosing, and whether insurance may help.
Whatto expect.
Book a consultationBotox is dosed in units and varies by area: roughly 50 units per underarm, 50 to 100 per palm, and about 100 total for the feet. You receive a personalized quote at your consultation. Medically necessary treatment may be covered by insurance, and we assist with pre-authorization and documentation.
Consultation, mapping of the sweat zones when needed, then a series of fine-needle injections. You return to normal activities immediately.
Minor redness or swelling at the injection sites is possible and settles quickly.
Dryness begins within two to seven days and reaches full effect around two weeks. Underarms often stay dry six to twelve months; palms and feet four to six months. Repeat treatments maintain the result.
Frequently asked questions
Is Botox FDA-approved for sweating?
It has been FDA-approved for underarm (axillary) hyperhidrosis since 2004. Palms, soles, and the face are treated off-label, with excellent results.
How does it work?
Botox is injected into the skin at multiple sites, where it temporarily blocks the acetylcholine signals from nerves that stimulate the sweat glands. The glands stop overproducing sweat and normal moisture regulation is restored.
How long do results last?
Underarm dryness often lasts 6 to 12 months. Palms and feet typically stay dry 4 to 6 months.
Does it hurt?
Discomfort is mild for most areas. Hands and feet are more sensitive because of nerve density, so numbing cream or ice is available.
Will the sweating just move somewhere else?
Compensatory sweating elsewhere on the body is very rare.
How soon will I see results?
Within 2 to 7 days, with the full effect at about 2 weeks.
Is there any downtime?
No. You can resume normal activities immediately. Temporary redness, swelling, or bruising at the injection sites is possible.
Will insurance cover it?
Cosmetic treatment is not covered, but medically necessary hyperhidrosis treatment may be. Our office helps with the pre-authorization and documentation your insurer requires.
How many units will I need?
Roughly 50 units per underarm, 50 to 100 units per palm, and about 100 units total for the feet. Your exact dosing is set at the consultation.
What are the possible side effects?
Temporary redness, swelling, or bruising at the injection sites. After palm injections, a temporary weakness of grip can rarely occur.
Who should not have this treatment?
It is not recommended during pregnancy or breastfeeding, or for people with certain neuromuscular conditions. Your medical history is reviewed at the consultation.
Can I combine it with other treatments?
Yes. It pairs easily with cosmetic Botox, laser treatments, and dermal fillers at the same practice.
Where to next
Related treatment
Botox
Soften lines and wrinkles.
Explore the treatmentRelated concern
Excessive Sweating
Sweat that antiperspirant cannot control
Start from the concernWorth reading
What are My Hyperhidrosis Treatment Options?
If you have hyperhidrosis, or excessive sweating, you know the embarrassment it can cause. This disorder mostly affects the underarms, the...
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Medically reviewed by Shalini Gupta, MD, Harvard-trained dermatologist and founder of The Dermatology, Laser & Vein Center. Last reviewed September 2026. This page is for education and is not a substitute for a personalized medical consultation.