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Botox for excessive sweating: How does it work?

University of Minnesota Health Dermatologist Lori Fiessinger, MD, explains how Botox can help people with hyperhidrosis, or excessive sweating.
Botox for excessive sweating? University of Minnesota Health Dermatologist Lori Fiessinger, MD, explains how this treatment option can help people with hyperhidrosis.
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Sweating is normal. In fact, it’s essential: Humans need to sweat in order to regulate body temperature.

But some people sweat much more than is needed. We spoke with University of Minnesota Health Dermatologist Lori Fiessinger, MD, who practices both medical and cosmetic dermatology, to learn about Botox injections for excessive sweating.

Hyperhidrosis, more commonly known as excessive sweating, can significantly affect a person’s quality of life. In some cases, problematic sweating is limited to one area of the body, such as the underarms or feet, a condition called focal hyperhidrosis. Other cases are more generalized, with sweating over large areas of the body. The most common areas affected by hyperhidrosis are the scalp, underarms, hands, feet and groin area.

“Excessive sweating can significantly affect a person’s life,” Fiessinger said. “It can be embarrassing and socially isolating, and many people find the condition quite upsetting.”

Botox—often associated with cosmetic wrinkle reduction—is also a particularly effective treatment for focal hyperhidrosis. Botox injections use botulinum toxin to block the nerve signals responsible for sweating, stopping the sweat glands from producing too much sweat. Retreatment is typically needed in four to six months, as the nerves regenerate. Over time, however, patients can go longer between treatments.

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“The injections are generally well tolerated by patients, and the treatment is very effective,” said Fiessinger, who is well versed in using Botox for both medical and cosmetic reasons. “The underarms, in particular, respond well. Sweat glands on the hands and feet also respond well to Botox injections, but patients tend to find the injections themselves more painful on the hands and feet because there are more nerve endings there.”

University of Minnesota Health dermatologists have extensive expertise in injection techniques and use that expertise to help reduce injection-related pain for patients. In addition, our team works with insurance companies to get these treatments approved for this medical condition.

“It’s important to be evaluated by a provider for excessive sweating, because there are a few other rare, serious conditions that can also cause excessive sweating symptoms,” Fiessinger said. Patients may also want to consider other options, like clinical-strength antiperspirant, before resorting to Botox.

Botox injections are most successful when hyperhidrosis is confined to one area of the body. Experts do not recommend Botox treatment for women who are pregnant or breastfeeding, or for people with a history of neuromuscular disorders. Because Botox can result in muscle weakness in the hands, dermatologists like Fiessinger will talk with patients to assess their career and lifestyle needs and determine whether Botox is the best option.

The procedure is simple. Numbing cream is applied to the treatment area up to one hour before the injections. The physician will clean the affected area and make many injections with a very tiny needle. Bruising, swelling, or tenderness is possible after the procedure, but is generally minor. Patients typically start seeing results in five days, with full results after two weeks.

“Botox has been a revolutionary treatment for hyperhidrosis: it has helped improve the quality of life for many patients,” Fiessinger said. “It’s a great treatment, it works well, and patients are really happy with the results.”


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