Hyperhidrosis, Excessive Sweating and Botox®

Hyperhidrosis or excessive sweating can be a very embarrassing and debilitating medical condition. Often patients that come to see me mention that they can’t wear certain clothes or even after showering and using an anti-perspirant the sweating can be seen as visible patches on their clothes. Other areas that can be effected and produce discomfort or embarrassment include the nose, forehead, scalp, chest, and abdomen. If this sounds familiar then Botox® may be the answer for you.

“Occasionally we also see people who would just like to not sweat under their arms (like those that work on stage or model) and by using Botox® it provides freedom to appear in public without worrying about visible sweat patches”. – Dr Alek Nikolic

Do you sweat “too much”?

If you do any of the following to cope with sweating, talk to your doctor about severe underarm sweating as Botox® may be the treatment for you:

  • Change your clothes frequently
  • Put absorbent materials under clothing
  • Avoid certain fabrics or clothing styles
  • Seek medical attention and treatment

If the above sounds familiar then Botox® can literally change your life.

What is Hyperhidrosis?

Hyperhidrosis is a medical condition that very simply causes excessive sweating. The word “hyperhidrosis” means too much (hyper) sweating (hidrosis).

Excessive sweating happens when a person sweats more than is necessary. We do need to sweat as sweating cools the body, which prevents us from increasing our body temperatures too much which can lead to heat exhaustion or heat stroke. People who have hyperhidrosis, however, sweat when the body does not need cooling.

Primary versus Secondary Hyperhidrosis

Excessive sweating is divided into two categories to help physicians and sufferers understand their cause which allows the correct approach to treatment. The two types of hyperhidrosis are: Primary Focal and Secondary Generalized. Understanding the difference is one of the most important steps in understanding hyperhidrosis.

Primary focal hyperhidrosis refers to excessive sweating that is not caused by another medical condition, nor is it a side effect of medications. The excessive sweating is the medical condition itself. This type of sweating occurs on very specific areas of the body (described as focal areas) and is usually relatively “symmetric” meaning that both the left and right sides of the body are affected similarly. The most common focal areas are the sweaty hands, sweaty feet, sweaty underarms, and sweaty face or head. Interestingly people who suffer from sweaty palms almost always also have sweaty feet.

Botox® and Hyperhidrosis

Botox has been shown to be an extremely effective treatment modality to stop sweating in select areas.

“Results typically last between 6 to 8 months and the procedure will have to be repeated for ongoing relief of sweating symptoms”. – Dr Alek Nikolic

How Does Botox Work:

Sweat glands are actually in the skin, not underneath it. When you sweat, a chemical messenger is sent to the sympathetic nerves that meet your sweat glands, turning the sweat ‘on’.

When Botox is injected, the toxin blocks the chemical messenger sent to your sympathetic nerves and so it does not reach the sweat glands. Without the chemical message, the glands cannot turn on the sweating. Botox blocks the nerve endings and so sweat cannot be produced.

I hope you found the above article helpful and has brought awareness that you do not need to suffer with visible and excessive sweating.

Kind regards

Dr Alek Nikolic


Frequently Asked Questions:

Is Botox safe?

Although Botulinum A is a natural protein derived from a toxin (Clostridium botulinum, the bacterium that gives us food poisoning, or botulism), it has been purified and refined, and is deemed safe and effective to use when administered by a specialist. It presents no major harm to the body when treating hyperhidrosis, and is only active in the specific area where it is injected; it does not spread throughout the body.

Does it hurt?

To help relieve the pain and discomfort, physicians can offer anaesthetic creams such as Emla, which contains lidocaine. In our practice we use a specially formulated high concentration lidocaine topical anesthetic which makes the procedure almost pain free. If discomfort is still intolerable you may be offered a nerve block which will take away most of the feeling in the area to be injected. The sensation usually returns to normal within 3-8 hours, and may prevent you from using your limbs as normal for that period of time. Some people, although few, feel that they can put up with the pain and do not opt for anaesthetics – it is totally your choice, which should be informed by your physician.

Does it work?

Medical studies and patient testimonials have confirmed that Botox reduces sweating and improves lifestyle; of course the level of reduction depends on each individual. However, Botox is not a cure for hyperhidrosis. As the nerve endings regrow, the sweating returns but at this stage you should receive top-up injections to start the cycle again, keeping the area dry. Sometimes sweat glands can be missed out and so you may experience a small level of sweating in some areas of your hands, feet or armpits. This is easily solved with top-up injections at your next appointment and you can bring it to the physician’s attention so they can concentrate on these areas.

Are there any patients Botox isn’t suited to?

Botox for hyperhidrosis is not recommended for pregnant women or mothers who are breastfeeding. It is also unsuitable for those with muscle or nerve disorders or on medications for nerve or muscle problems. Those with neuromuscular disease, Myasthenia Gravis or Lambert-Eaton syndrome are also unable to have this treatment.

How can I receive this treatment?

Botox should only be administered by a trained medical physician or doctor who has had specific training in the treatment of hyperhidrosis

2 replies
  1. Niki Diamond
    Niki Diamond says:

    What is the price for underarm botox?
    My 16 year old daughter is very conscious of her sweaty underarms.
    Thx Niki

    • Dr Alek Nikolic
      Dr Alek Nikolic says:

      Hi Niki and thank you for the question and my apologies for the delay in my response. We charge R 5,100.00 for the Botox treatment as 50 units is used per axilla (arm pit area). Results should last around 6 months. If you would like to make an appointment please phone Samantha at 021 7970960. I hope this has helped but if you need any further info please let me know. Kind regards Dr Alek.


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