BOTOX helps against heavy sweating

Excessive sweating is unpleasant for those concerned. Especially when there is no apparent reason. The condition, medically described as “hyperhidrosis”, is quite widespread, and the causes are often diffuse. Particularly affected parts of the body are the hands, feet, and armpits. Excessive sweating under the armpits is the case I encounter most typically in my Munich practice. Hyperhidrosis on the face also occurs, although much less frequently.


What exactly “excessive” sweating means depends on subjective perception. For scientific purposes, a sweat production of 100 mg in 5 minutes has been defined as threshold. The use of botulinum toxin against hyperhidrosis makes sense if you can no longer cope with everyday life without sweating and if your condition has a negative effect on your self-confidence or on your social life. In the past, surgery was regularly the only option in such cases. However, removing the sweat glands is not without side effects and also not without risk. Using Botox to treat hyperhidrosis is therefore a perfectly sensible alternative in many cases.


The first indication of hyperhidrosis is the excessive sweating itself. Preferably in the typical areas of the body such as the armpits, palms of the hands and soles of the feet. If the three criteria

  1. excessive sweating in the typical body zones
  2. no other health problems
  3. no known underlying diseases

are fulfilled, then the diagnosis of hyperhidrosis is obvious.

If there are indications of an existing underlying disease that could be the cause of the hyperhidrosis, further examinations must be carried out. Such underlying diseases may include hyperthyroidism, other hormonal disorders, neurological diseases, mental illnesses, infectious diseases and high blood pressure. In addition, heavy sweating can be triggered by stress and persistent anxiety.

Gravimetric Testing

Medical practitioners determine the exact amount of sweat per minute using gravimetry. In this procedure, the sweat formation is detected and measured with a iodine strength test. If the result suggests hyperhidrosis, various medicinal therapies were considered in the past and, if they failed, finally surgical excision of the sweat glands was performed. What all surgical procedures have in common, however, is that they can sometimes have unpleasant side effects, while their success is by no means certain.


Today, the use of botulinum toxin opens up a much lower-risk option with comparable results. Botox, which is widely known as wrinkle-treatment, is also a viable treatment option for excess sweating. The botulinum toxin inhibits the signal transmission from the nerve to the muscle, which is thus paralysed. Thus, wrinkles can no longer form.

The same mechanism of action is found in the sweat glands. Botox also blocks the signal transmission from the nerve to the sweat gland. This reduces the sweat secretion. Outbreaks of excess sweating are prevented. If the treatment is properly performed, Botox works with a high degree of reliability against excess sweating.

The Process

During the treatment, the botulinum toxin is injected into the skin at square centimetre intervals in a slightly higher dilution than usual. An injection pattern of 10–20 points on average is used per armpit. For patient comfort, the thinnest needles available are used. To prevent any pain, the treatment area is numbed with topical anaesthetic before the Botox injections.

It takes about 1 – 2 weeks for the botulinum toxin to take effect. Therefore, the excess sweating will not stop immediately after treatment. However, an improvement should be noticed already after 3–5 days. From then on, the effect will last between 3 and 6 months. Thereafter, the treatment has to be repeated. Possible complications, for example small bruises in the injection zone or a light headache, will disappear after a few days.

As already mentioned, botulinum toxin is very effective in treating hyperhidrosis. Patients who have undergone this treatment are mostly satisfied with the results. Studies show that after repeated treatment, heavy sweating can be almost eliminated. In most severe cases of hyperhidrosis, the treatment with Botox has made it possible to avoid surgical removal of the sweat glands.

Attractive at every age

LIPS and SKIN Aesthetic Medicine

Eva Maria Strobl, MD
Herzog-Heinrich-Strasse 34
80336 Munich