Information on botulinum toxin for hyperhidrosis
Hyperhidrosis is sweating beyond what the body needs to regulate temperature. Primary hyperhidrosis usually affects the underarms, palms, soles or face and can affect daily life. Botulinum toxin type A aims to reduce sweating in these areas by temporarily reducing the nerve signal that stimulates the sweat glands.
Assessing the cause first
Sweating that starts recently, affects the whole body, occurs with night sweats, or comes with weight loss or fever may be related to thyroid disease, infections, certain medicines or other health problems; the cause should be investigated first. In mild cases, simpler options such as topical aluminium-salt products may come first.
Evidence and expectations
For underarm hyperhidrosis, randomized controlled trials and meta-analyses have shown a marked reduction in sweating and improved quality of life with botulinum toxin. Evidence for palms and soles is more limited. The effect usually begins within a few days and lasts several months; it is not permanent.
Treatment details
Duration: About 30–45 minutes.
Who it is for: Adults with primary excessive sweating whose cause has been assessed.
Number of sessions: A single session; the need for repetition is usually assessed months later according to symptoms. The final plan is set by the physician after the examination.
Possible risks
Pain, bruising and temporary tenderness at injection sites may occur. Palm injections can be more painful and may cause temporary hand-muscle weakness. Some people notice increased sweating elsewhere. Generalized muscle weakness or difficulty swallowing or breathing requires urgent medical assessment.
Who may not be suitable?
Infection in the area, a history of neuromuscular disease, pregnancy and breastfeeding, allergy to a product component and interacting medicines are assessed separately.
Aftercare
Not massaging the area on the first day and briefly avoiding intense exercise may be advised. The effect is assessed after a few days.
Frequently asked questions
Which areas are treated?
The underarms are assessed most often. Palms, soles and the face or scalp require separate assessment.
How long does it last?
The effect is not permanent and its duration varies. Repeat treatment is decided by symptoms.
Does it stop sweating completely?
The aim is to reduce sweating; complete cessation is not expected and no result can be guaranteed.
This text is intended for general information and is not personalized diagnostic or treatment advice. Eligibility is determined after a medical history and examination. Outcomes may vary from person to person; a specific result cannot be guaranteed.
References
- Sun J, et al. Efficacy and Safety of Botulinum Toxin Type A in Primary Axillary Hyperhidrosis: A Meta-analysis and Systematic Review. Aesthetic Plast Surg. 2025. PMID: 40500510.
- Wade R, et al. Interventional management of hyperhidrosis in secondary care: a systematic review. Br J Dermatol. 2018. PMID: 29573391.
- Stuart ME, et al. A systematic evidence-based review of treatments for primary hyperhidrosis. J Drug Assess. 2020. PMID: 33489435.
