Botox for sweating – Hyperhidrosis treatment
Drs. Tom van Eijk
Botox for sweating is a temporary treatment in which botulinum toxin is injected into the skin to reduce nerve signals that activate sweat glands. It is mainly used for excessive underarm sweating, known as axillary hyperhidrosis.
On this page, we use “Botox” because it is a common search term. Botox is a brand of botulinum toxin. A clinic may use another botulinum toxin product, and the licensed uses, dosing and product information can differ.
The treatment aims to reduce sweating in the injected area. It cannot guarantee that your underarms will remain completely dry, does not treat every possible cause of excessive sweating and is not permanent.
A consultation should include your sweating pattern, medical history, medicines, previous treatments and expectations. Having a consultation does not mean you have to continue with treatment.
For broader information about other uses of botulinum toxin, see the Botox treatment overview.
When is sweating considered excessive?
Hyperhidrosis means sweating more than your body needs for normal temperature control. It may affect one area, such as the underarms, hands or feet, or be more widespread.
Sweating because you are hot, exercising or under stress can be normal. With axillary hyperhidrosis, your underarms may become noticeably wet even when there is no obvious need for your body to cool itself.
Primary and secondary hyperhidrosis
Primary focal hyperhidrosis describes excessive localised sweating without another cause being identified. Secondary hyperhidrosis is sweating associated with another medical condition or factors such as medication.
Sudden-onset sweating, night sweats, sweating across much of the body or sweating accompanied by other unexplained symptoms should be medically assessed. Treating the sweat glands does not investigate or treat an underlying condition.
Which areas can be treated with botulinum toxin for sweating?
Underarms
The underarms are the main focus of this page. The BOTOX brand has a UK indication for severe axillary hyperhidrosis that has not responded adequately to topical antiperspirant treatment.
During treatment, multiple small injections are distributed through the active sweating area rather than placing one injection into each underarm.
Hands
Botulinum toxin may also be used by some practitioners for excessive sweating of the palms. Treatment can be more uncomfortable than underarm injections, and temporary effects on nearby hand muscles are an additional consideration.
Feet
Treatment may also be considered for excessive sweating of the soles. The injections can be sensitive, so pain-management options may need to be discussed separately.
Face or scalp
Some practitioners treat localised facial or scalp sweating with botulinum toxin. This is not the main indication covered on this page and requires a separate assessment of anatomy, product use and individual risk.
When might Botox for sweating be considered?
A consultation may be worth considering when excessive localised sweating keeps returning, has a meaningful effect on daily activities and measures such as stronger antiperspirants have not provided sufficient control.
Examples can include:
both underarms becoming noticeably wet without heat or exercise;
frequently needing to change tops because of underarm sweat;
choosing clothes mainly to hide sweat marks;
sweating interfering with work, study or social activities;
persistent underarm sweating despite appropriate antiperspirant use;
skin irritation making some topical products difficult to continue.
These signs do not automatically mean botulinum toxin is appropriate for you. A practitioner should consider the pattern of sweating, what you have already tried, relevant medical history and whether further medical assessment is needed first.
Choosing not to have injections remains a valid option.
What happens during treatment for underarm sweating?
- 1 Consultation and medical history
- 2 Assess the sweating pattern
- 3 Map or mark the active underarm area
- 4 Give multiple superficial injections
- 5 Provide treatment-specific aftercare
- 6 Review the response after the treatment has taken effect
When does Botox for sweating start working?
The reduction in sweating is not normally immediate. With the BOTOX brand, UK product information states that clinical improvement generally occurs within the first week.
During the first few days
The injection sites may initially feel tender and small areas of swelling or redness can occur. Sweat reduction may begin to become noticeable as the botulinum toxin starts reducing signalling to the sweat glands.
Around two weeks
Around two weeks is a practical point at which many clinics assess the overall response. Partial sweating can remain. The goal is a meaningful reduction in excessive sweating rather than guaranteed complete dryness.
How long does Botox for sweating last?
For primary axillary hyperhidrosis treated with the BOTOX brand, current UK product information describes an effect lasting approximately 4–7 months.
The duration can still differ between individuals. When the effect wears off, sweating generally returns gradually rather than switching back on at one specific time.
If the response remains much smaller than expected after the agreed assessment period, read about possible next steps when Botox does not work as expected.
How can the result of treatment for underarm sweating be assessed?
A useful assessment is based on changes in sweating rather than simply whether the skin looks dry in one photograph.
Before treatment
A practitioner may use a Minor iodine-starch test to map the most active sweat-producing area. Iodine is applied to the skin followed by starch, causing areas of active sweating to change colour.
After treatment
If the assessment is repeated under comparable conditions, it may help show whether the active sweating area has become smaller or less intense.
Daily-life changes are also relevant. These could include fewer visible sweat marks, needing to change clothes less often or spending less time planning around underarm sweating.
A standard photograph of a dry underarm does not reliably measure sweat production. Before-and-after images should therefore be interpreted cautiously unless the method and timing of the comparison are clear.
How much does Botox for sweating cost in the UK?
The price of treatment for excessive underarm sweating can differ between clinics because the treatment area, botulinum toxin product, treatment plan and services included in the quoted fee can differ.
Check whether a listed underarm price covers both underarms and whether consultation, review appointments or any further assessment are included.
For broader information about how botulinum toxin treatment prices are structured, see Botox costs in the UK.
What should you check when comparing prices?
The lowest listed price is not automatically the most useful comparison. First establish what the price actually covers.
Does the price include both underarms?
A generic “hyperhidrosis” price may not tell you whether it refers to one area, both underarms or another treatment zone.
Which botulinum toxin product is being used?
Botulinum toxin units are product-specific. A numerical unit count for one product should not automatically be compared one-to-one with the units of another product.
What is included after treatment?
Check whether the quoted fee includes a review and what happens if the reduction in sweating is clearly below the expected response after the agreed assessment period.
Is the consultation included?
Ask whether the initial medical assessment is part of the treatment price or charged separately.
What are the disadvantages of Botox for sweating?
The main limitations are that the effect is temporary, the treatment involves multiple injections, repeat treatment can create recurring costs and the reduction in sweating may be smaller or shorter-lived than expected.
Injection-site reactions can occur, and botulinum toxin has wider possible side effects and complications that should be discussed before treatment.
Another limitation is that botulinum toxin reduces sweat production in the treated area but does not investigate why excessive sweating started. Where the sweating pattern suggests a possible secondary cause, medical assessment can be more important than proceeding directly to injections.
Safety, medical considerations and aftercare
Temporary reactions after underarm injections
Injection-site pain, tenderness, swelling, redness or bruising can occur after treatment. Headache and changes in sensation are also listed among possible reactions in product information for axillary hyperhidrosis.
Increased sweating outside the treated underarm area has also been reported. In BOTOX clinical data, non-axillary sweating was reported in 4.5% of patients within one month of treatment. This does not mean it will occur in every person or with every treatment plan.
When treatment may need to be postponed or reconsidered
An active infection, broken skin or significant irritation in the treatment area may be a reason not to inject that area at that time.
Relevant neurological or muscular conditions, allergies and other medical circumstances can also change whether treatment is appropriate. These need individual medical assessment rather than a checklist-based decision online.
Medicines and medical conditions to mention
Tell the practitioner about prescription medicines, non-prescription medicines and relevant medical conditions before treatment.
Some medicines that affect neuromuscular transmission can interact with botulinum toxin. Medicines affecting bleeding may also matter because multiple injections are required.
Do not stop prescribed medication yourself in preparation for treatment. Any medication change should be discussed with the clinician responsible for prescribing it.
Pregnancy and breastfeeding
Current UK product information for BOTOX does not recommend its use during pregnancy. Its use during breastfeeding also cannot be recommended because there is insufficient information about excretion into human milk.
For a fuller treatment-specific discussion, see Botox during pregnancy.
When should you contact the clinic or seek medical help?
Contact the treating clinic if symptoms are severe, clearly worsening or different from what you were told to expect.
Seek urgent medical help for acute difficulty breathing or swallowing or signs of a severe allergic reaction. These are not expected routine after-effects.
For a broader explanation of risks, see possible Botox treatment complications.
What about aftercare?
Follow the instructions given for the exact product and treatment protocol used by your clinic. Avoid unnecessarily rubbing or irritating injection sites while they remain red, swollen or sensitive.
Ask the clinic when you can restart deodorant, shaving, strenuous exercise and other activities if this has not been made clear. Protocols can vary, so do not assume that generic instructions from another Botox treatment automatically apply to underarm hyperhidrosis.
Botox or another treatment for excessive sweating?
Botulinum toxin is one option for managing excessive sweating. It is not automatically the appropriate first or only treatment.
Stronger antiperspirants
Products containing aluminium salts can reduce sweating and are commonly tried before injections. Skin irritation can limit their use for some people.
Iontophoresis
Iontophoresis uses a weak electrical current and is particularly associated with excessive sweating of the hands and feet.
Medicines
Some medicines can reduce sweating across the body. Because they act systemically, they can also cause effects outside the area causing the original problem.
Other procedures
Other interventions may be considered in selected cases, including treatments aimed at the underarm sweat glands or surgery. Their suitability, invasiveness and risks differ from botulinum toxin treatment.
The most appropriate next step depends on the area affected, the severity and pattern of sweating, possible underlying causes and treatments already tried.
How do you compare clinics for Botox for sweating?
Treatment for axillary hyperhidrosis requires more than general experience with cosmetic facial injections. Compare clinics on factors that are directly relevant to excessive sweating.
Relevant professional background
Check the practitioner's professional title, registration where applicable and clinical background. A professional title alone does not prove extensive experience with hyperhidrosis treatment.
Experience with axillary hyperhidrosis
Ask whether the practitioner regularly assesses and treats excessive underarm sweating rather than only performing facial botulinum toxin injections.
Assessment before treatment
The practitioner should ask about your sweating pattern, relevant medical history, medication and previous treatments. They should also recognise when possible secondary sweating needs medical investigation.
Treatment planning
Ask how the sweating area will be identified, which botulinum toxin product is being considered and what the treatment aims to achieve.
Review and follow-up
Check when the response will be assessed and what the clinic's process is if there is a limited or uneven reduction in sweating.
For broader guidance, see how to compare a Botox practitioner.
Experiences with Botox for sweating
Reviews can provide context about how other clients experienced the consultation, injections, explanation, communication and follow-up.
For this treatment, prioritise reviews that clearly refer to hyperhidrosis or excessive sweating rather than reviews about facial Botox. A positive review does not prove that the treatment is medically suitable or predict the reduction in sweating another person will experience.
You can also read the broader collection of Botox reviews.
Reviews of treatment for excessive sweating
Sherena treated me for excessive sweating on my face. Facial Hyperhidrosis.
It was a simple procedure. Painless and all done in a professional reassuring manner.
Sherena put me at ease with her friendly manner.
The treatment has worked perfectly. I have spent years looking for a solution. I thoroughly recommend getting in touch with the Windsor clinic in Downpatrick.
It has been life changing for me. Show less »
Compare UK clinics for Botox for sweating
Clinics can differ in the botulinum toxin product they use, how they assess the active sweating area, what their quoted price includes and how follow-up is handled.
Use the clinic information below to compare relevant options. Review the treatment details for each clinic before deciding whether to request a consultation.
Compare clinics in United Kingdom
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- Botox in the armpits from
- £ 595,00
- Botox in the armpits from
- £ 510,00
- Botox in the armpits from
- £ 510,00
- Botox in the armpits from
- £ 510,00
Frequently asked questions about Botox for sweating
What does Botox for sweating do?
Botulinum toxin temporarily reduces the nerve signals that activate sweat glands in the treated area. This page focuses mainly on excessive underarm sweating, or axillary hyperhidrosis.
When does Botox for underarm sweating start working?
For the BOTOX brand, current UK product information states that clinical improvement generally occurs during the first week. The overall response is often reviewed after the treatment has had more time to develop.
How long does Botox for sweating last?
For BOTOX treatment of primary axillary hyperhidrosis, UK product information describes an effect lasting approximately 4–7 months. Duration varies between individuals.
Does Botox stop underarm sweating completely?
Not necessarily. The aim is to reduce excessive sweat production in the treated area. Some sweating may remain, and complete dryness cannot be guaranteed.
How many injections are used for underarm sweating?
Multiple small injections are distributed across the active sweating area of each underarm. The exact pattern depends on the product and treatment plan rather than one standard number that applies to every treatment.
Is Botox for sweating painful?
You receive multiple superficial injections, so stinging or injection-site pain can occur. How uncomfortable this feels varies between people and treatment areas.
Can you sweat more somewhere else after treatment?
It is possible. Increased sweating outside the underarms is listed in BOTOX product information. In clinical data, non-axillary sweating was reported in 4.5% of patients within one month after treatment.
What if Botox does not reduce my sweating enough?
Contact the treating clinic after the agreed assessment period. The practitioner can review the treated area, response and treatment plan before deciding whether any further step is appropriate. See more about what can happen when Botox does not work as expected.
Can Botox for excessive sweating be available through the NHS?
NHS availability can vary. NHS guidance states that Botox injections for underarm sweating are one possible specialist treatment but may not be available on the NHS. For broader information, see Botox reimbursement and funding.
Does Botox for sweating prevent body odour?
Botulinum toxin reduces sweat production but does not directly treat the skin bacteria involved in body odour. Reducing moisture may affect the conditions in which odour develops, but an odour-free result cannot be guaranteed.