OnabotulinumtoxinA Injections (Botox®)

In 2004, for the first time in decades, the U.S. Food & Drug Administration (FDA) approved a new treatment for excessive sweating of the underarms (axillary hyperhidrosis). Specifically, on Monday, July 19, 2004, the FDA approved BOTOX (onabotulinumtoxinA) for the treatment of severe primary axillary hyperhidrosis in patients unable to obtain relief using antiperspirants. BOTOX is produced by Allergan, Inc., of Irvine, California, and it is the most studied brand of botulinum toxin in the world. BOTOX has been available for well over a decade and has been used to treat more millions of patients with various conditions, including spasticity and movement disorders. With FDA approval, the United States joins more than 20 other countries that have already approved the use of BOTOX for excessive sweating. (For complete prescribing information on Botox for hyperhidrosis, click here.)

Using local injections of Botox (onabotulinumtoxinA) to alleviate the symptoms of hyperhidrosis is a promising approach. Research has shown that treating excessive sweating of the armpits, hands, feet, and face with onabotulinumtoxinA is safe and effective. In one clinical study involving 322 patients with severe underarm sweating, 81% of the patients receiving botulinum toxin injections achieved a greater than 50% reduction in sweating. And, 50% of the patients had their excessive sweating relieved for at least 201 days (nearly 7 months). 

OnabotulinumtoxinA is a natural, purified protein with the ability to temporarily block the secretion of the chemical that is responsible for "turning on" the body's sweat glands. By blocking, or interrupting, this chemical messenger, botulinum toxin "turns off" sweating at the area where it has been injected.

While sweating is an essential body function for temperature-control, the underarms house less than 2% of the body’s sweat glands. The treatment of these sweat glands has no effect on body thermoregulation and compensatory sweating (sweating on other body parts, common after ETS surgery) has not shown itself to be a concern.

Using Botox Injections Effectively

The use of Botox for the treatment of hyperhidrosis can be most effective when performed by a physician who has received special training from the International Hyperhidrosis Society and who has experience with the procedure. To find a physician in your area who is familiar with hyperhidrosis treatments, use our Physician Finder. Physicians who have attended an International Hyperhidrosis Society educational event (which includes intensive training on using Botox to treat hyperhidrosis) are highlighted.

Injections can be administered in a physician's office, require relatively little time, and do not demand any restrictions in work or leisure activity (aside from refraining from intensive exercise or the use of a sauna on the day of the injections).

During the procedure, a very fine needle is used to inject tiny amounts of Botox just under the skin near in the area of excessive sweating every 1 to 2 centimeters. Multiple injections are given based on your doctor's assessment of the area that needs to be treated. Injections into the palms or soles may be somewhat painful. To ease discomfort, physicians may use one or more of a number of anesthetic techniques such as ice or vibrations. Treatment of the underarms is usually not painful and easy to withstand.

There is a possibility that during the procedures some sweat glands may be missed. As a result, you may continue to experience some sweating from the areas missed. If this happens, it's important to talk to your doctor so that he or she can reevaluate the sweating areas and perhaps "fill in" the gaps with additional injections. This usually takes care of any sweating in the treated areas.

Botulinum toxin injections do not cure hyperhidrosis; your symptoms will go away gradually (usually in about a week) and return gradually. Follow-up injections are required to maintain dryness. These repeat injections may be necessary at intervals varying from seven to sixteen months.

Next Steps

Have you talked to your doctor about excessive sweating? If not, now is the time! Learn more about how you and your doctor can work together to find the right treatment, or combination of treatments, to manage your hyperhidrosis.

Are you interested in trying local botulinum toxin injections for hyperhidrosis? As mentioned above, our Physician Finder can help you locate physicians who treat hyperhidrosis. Use it today!

Finally, you may want to consider participating in a clinical trial. Patients enrolled in clinical trials often receive treatments free of charge. Visit our Clinical and Market Research page to find out more and whether you're eligible to participate.

And remember, because hyperhidrosis is a serious medical condition - you deserve insurance coverage and reimbursement for your doctor's visits and treatments, We've got tips to help you navigate the health insurance realm; visit Insurance Tools for more information. If you are seeking financial assistance for axillary hyperhidrosis treatment with Botox specifically, you may find help through Allergan's generous assistance programs.