Botox for excessive sweating

How it works

The same mechanism that relaxes muscle also blocks the signal to the sweat glands. Injected into the dermis of the underarm, botulinum toxin interrupts the nerve supply to the eccrine glands, and sweating in the treated area drops sharply.

Onset is two to seven days, faster than facial treatment. Duration is six to nine months, considerably longer than the face, and many patients settle into treating once or twice a year.

Compensatory sweating elsewhere is far less of an issue than with surgical sympathectomy, but some patients do notice a modest increase in other areas. It is worth being told before rather than discovering it.

What it costs, and why

Fifty units per underarm. This is the indication where product is essentially the whole price.

Consultation is free and the 15-day review is included. The full rate for every area is on the price page.

It is the most expensive thing on our price list and the reason is simple arithmetic: 100 units of product against the 16 to 24 a glabella takes. There is no package for it because there is no margin to package — you are paying for the toxin.

The comparison patients usually make is against six to nine months of ruined shirts, dry cleaning and clinical-strength antiperspirants, and against what the same treatment costs in the United States, where it commonly runs USD 1,000 to 1,500.

Who it suits

The clearest indication is primary focal hyperhidrosis: excessive sweating localised to the underarms, present since adolescence, not explained by another condition, and not responding to prescription-strength aluminium chloride antiperspirants.

Before treating, secondary causes are worth excluding — thyroid disease, certain medications, infection, and hormonal changes can all drive sweating, and treating the symptom while missing the cause helps nobody.

Palms and soles can also be treated, and the response is good, but it is considerably more painful and requires nerve blocks. It is assessed case by case rather than offered off a price list.

What the session is like

The underarm is mapped first — usually with a starch-iodine test that stains the actively sweating area, so the injections cover the region that is actually producing rather than a guess. Then roughly twenty small intradermal injections per side.

It is more uncomfortable than facial treatment because there are more injection points, but each one is very superficial and very fast. Topical anaesthetic makes a meaningful difference here and is worth using. The whole thing takes about thirty minutes and there is no downtime.

Frequently asked questions

Medical references

The clinical claims on this page rest on public, verifiable sources. They are cited so you can check them, not as an endorsement of this practice by those organisations.

• Aesthetic Surgery Journal (2025) — systematic review of HIFU in skin tightening and body contouring
• Lasers in Medical Science (2020) — systematic review and meta-analysis of HIFU safety and efficacy for face and neck
• American Academy of Dermatology — wrinkles and treatment options
• INVIMA — medical device registration in Colombia