What Does Research Say?

Research demonstrates that treating excessive sweating of the armpits, hands, feet, head and face (craniofacial), and other relatively small body areas (like under the breasts) with onabotulinumtoxinA is safe and effective. When used to treat underarm excessive sweating, Botox has been shown to result in an 82-87% decrease in sweating.

Results start to be noticeable approximately 2 to 4 days after treatment with the full effects usually noted within 2 weeks. Dryness typically lasts 4 to 12 months, but some studies have found it can last as long as 14 months. Additional statistics from published research studies have shown that repeated treatment with Botox is safe and effective for hyperhidrosis and consistently results in meaningful, long-lasting improvements in an excessive sweating patient’s symptoms, daily functioning, and quality of life.

Understanding Sweating

Sweat is essential to human survival and serves as the body’s coolant, protecting it from overheating.

There are two to four million sweat glands distributed all over our bodies. The majority of them are “eccrine” sweat glands, which are found in large numbers on the soles of the feet, the palms, the forehead and cheeks, and in the armpits.

Eccrine glands secrete an odorless, clear fluid that helps the body to control its temperature by promoting heat loss through evaporation. In general, the type of sweat involved in hyperhidrosis is eccrine sweat.

The other type of sweat gland is called an “apocrine” gland. Apocrine glands are found in the armpits and genital region. They produce a thick fluid. When this fluid comes in contact with bacteria on the skin’s surface, it produces a characteristic potent “body odor”.

What Are The Stimuli?

Both the eccrine and apocrine sweat glands are activated by nerves. These nerves respond to a variety of stimuli including:

• messages from the brain indicating that the body is too hot
• hormones
• emotions
• physical activity or exercise.

In people who have excessive sweating, or hyperhidrosis, the sweat glands (eccrine glands in particular) overreact to stimuli and are just generally overactive, producing more sweat than is necessary. It’s often said that people with hyperhidrosis have sweat glands that are stuck in the “on” position.

Contrary to a popular myth on the internet, sweat is NOT made up of toxins and therefore you don’t ‘sweat out’ toxins. Rather, sweat is made up of 99 percent water and small bits of carbs, salt, protein and urea. The kidneys and liver are the organs responsible for detoxing your body (not the sweat glands).

How do Botox injections work?

Botox works by blocking the nerves responsible for activating your sweat glands. 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.

Where is Botox used?

Currently, Botox has only been approved for the treatment of underarm sweating. In studies, Botox was extremely effective in treating underarm sweating. Doctors use it “off-label” to treat other areas of the body.

Studies have found that Botox successfully treats sweaty palms in 80 to 90 percent of cases. However, the treatments don’t last quite as long as the underarm treatments. Studies also show that Botox works to treat forehead sweat. It can reduce sweating by 75 percent for about five months.

Researchers believe that Botox could help with sweating on the soles of the feet, however few studies have been done. Of particular concern is that injections in the feet are considerably more painful than other areas.