Botulinum toxin type A (BTX-A) is a medication that is injected subdermally into the skin to treat hyperhidrosis. Botox acts by temporally blocking neurotransmitters that stimulate sweat production. Botox works well for axillary hyperhidrosis. It is injected at 15-20 sites in the underarm. A decrease in sweating is noted after the injections. However repeat treatments are needed every 4-6 months.

Botox injections are painful but if the pain can be tolerated this therapy may be beneficial in patients with axillary hyperhidrosis. Cost is another issue since botox injections are expensive and since the treatments have to be repeated every 4-6 months the expense may be substantial.

Botox injections also have been used to treat palmar and facial hyperhidrosis with some success. However most patients are reluctant to receive multiple injections in their hands and face. Botox has also been associated with temporary paralysis of the hand muscles.

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