From the FDA Drug Label
BOTOX is also injected into the skin to treat the symptoms of severe underarm sweating (severe primary axillary hyperhidrosis) when medicines used on the skin (topical) do not work well enough
- Treatment options for hyperhidrosis include botulinum toxin (BOTOX) injections into the skin for severe underarm sweating when topical medicines are not effective enough 1.
- The use of BOTOX for hyperhidrosis is specifically approved for severe primary axillary hyperhidrosis, indicating its application for excessive sweating in the underarm area.
- It is essential to consult a doctor to determine the best course of treatment for hyperhidrosis, as the suitability of BOTOX or other treatments depends on individual medical conditions and history.
From the Research
Treatment for hyperhidrosis should start with clinical-strength antiperspirants containing aluminum chloride, and for more severe cases, botulinum toxin injections are a highly effective option, as shown in a study comparing botulinum toxin type A with topical 20% aluminum chloride, where 92% of subjects in the botulinum toxin group achieved treatment response 2.
Treatment Options
- Clinical-strength antiperspirants containing aluminum chloride (like Drysol or Certain Dri) for mild cases
- Oral medications such as anticholinergics like glycopyrrolate (1-2mg twice daily) or oxybutynin (5-10mg daily) for moderate cases, but may cause side effects like dry mouth and constipation
- Iontophoresis, which uses a mild electrical current through water to temporarily block sweat glands, requires 20-30 minute sessions several times weekly initially, then maintenance treatments
- Botulinum toxin (Botox) injections provide 4-6 months of relief for focal hyperhidrosis, particularly for underarms, palms, and soles, though they can be painful and costly, and have been shown to improve life quality in severe primary focal hyperhidrosis 3
- For severe cases unresponsive to other treatments, endoscopic thoracic sympathectomy (ETS) surgically interrupts the sympathetic nerves controlling sweating, but carries risks of compensatory sweating elsewhere
- MiraDry uses microwave technology to permanently destroy underarm sweat glands in 1-2 office treatments
Considerations
- Treatment selection depends on the affected body area, severity of sweating, patient preferences, and potential side effects
- Combination therapy with aluminum chloride hexahydrate and botulinum toxin type A can be effective for patients with moderate to severe hyperhidrosis who do not completely respond to botulinum toxin type A injections alone 4
- Topical glycopyrrolate can be used to treat gustatory hyperhidrosis, with a study showing excellent results in 77% of patients 5