

Botox treatment for underarm sweating is one of the non-surgical methods that can significantly reduce sweating in primary axillary hyperhidrosis. Botulinum toxin temporarily reduces the nerve signals reaching the sweat glands in the underarm area and suppresses sweat production in the treated region.
Underarm Botox may be considered especially in people who do not obtain sufficient benefit from antiperspirant products, develop visible wet patches on clothing, and experience social or professional difficulties because of sweating.
The treatment can substantially reduce sweating in many patients. In some people, the underarm area becomes almost completely dry, while in others sweating does not stop entirely but decreases to a level that affects daily life less.
Botox is not a permanent treatment. It does not destroy the sweat glands, cut the sympathetic nerves, or eliminate the body’s general sweating mechanism. Its effect gradually decreases, and sweating may return. For this reason, the success of underarm Botox should not be assessed only by asking, “Has sweating stopped completely?” Clothing wetness, daily comfort, social anxiety, odour, quality of life, and duration of effect should also be considered.
Underarm sweating occurs through the activity of the sweat glands in the axillary region. Sweating under the arms during hot weather, exercise, stress, or excitement is normal.
However, axillary hyperhidrosis may be considered if underarm sweating occurs intensely even when the body does not need to cool down, causes persistent wetness on clothing, and affects daily life.
Primary axillary hyperhidrosis usually:
In secondary underarm sweating, sweating may be associated with thyroid disease, low blood sugar, infection, hormonal changes, medications, or another systemic cause.
Underarm sweating is not only a problem of physical wetness. When severe, it may affect clothing habits, work life, social relationships, and self-confidence.
People with axillary hyperhidrosis may:
These effects are important when deciding on treatment. The severity of hyperhidrosis is evaluated not only by the amount of sweat produced but also by how much it affects the person’s life.
The sweat glands in the underarm area are controlled by the nervous system. A chemical substance called acetylcholine is released from nerve endings and signals the sweat glands to work.
Botulinum toxin temporarily reduces acetylcholine release in the treated area. As a result, the signal reaching the sweat glands weakens and the amount of sweat produced in the underarm area decreases.
Botox:
Underarm Botox is therefore considered a temporary but effective local treatment.
Underarm Botox can significantly reduce sweat production in appropriately selected patients with primary axillary hyperhidrosis.
Clinical studies have reported a marked decrease in sweat production, improvement in hyperhidrosis severity scores, and better quality of life after botulinum toxin treatment.
After effective treatment, patients may usually notice changes such as:
The effect varies from person to person. In some people, the underarm area becomes noticeably dry, while in others only partial reduction occurs. Botox should therefore not be seen as a method that guarantees the same result in every patient.
Studies have reported high rates of sweat reduction after underarm Botox. In suitable patients, sweat production may decrease by approximately 80% or more.
However, this percentage does not apply identically to every patient. Results may vary according to:
For this reason, the question “What percentage effective is it?” should not be answered with a single fixed number. Clinically, the important point is whether the patient experiences meaningful relief in daily life.
Underarm Botox may almost completely stop sweating in some people. In others, sweating does not disappear entirely but decreases significantly.
The purpose of treatment is not to eliminate the body’s natural sweating mechanism completely. The aim is to reduce excessive and uncontrollable underarm sweating to a level that no longer interferes with daily life.
A completely dry underarm is not required for a successful result. Not experiencing clothing wetness, needing less deodorant, feeling more comfortable with clothing choices, and feeling more confident in social situations may also be considered treatment success.
The effect of botulinum toxin does not begin fully at the moment of injection.
A reduction in underarm sweating may usually begin within the first few days. In most people, the effect becomes more noticeable within 7 to 10 days. In some patients, full assessment of the effect may take approximately two weeks.
Continued sweating during the first few days does not mean that treatment has failed.
If sweating continues in specific areas after two weeks:
The doctor should decide whether an additional application is necessary.
The effect of underarm Botox is not permanent. Duration varies from person to person but generally lasts several months.
In many patients, the effect of underarm Botox may last approximately 3 to 10 months. In some people, the effect may be shorter, while in others it may last longer.
Factors that may affect duration include:
Sweating usually does not return to its previous level suddenly. As the effect of the medication decreases, nerve stimulation reaching the sweat glands gradually increases and sweating may slowly return.
There is no fixed repeat interval that applies to everyone.
Treatment may usually be repeated when:
Repeating the procedure unnecessarily early while the effect is still active is not appropriate. The timing is determined according to the patient’s response.
Some people may remain comfortable for a long period with one treatment per year. Others may need evaluation at shorter intervals.
Underarm Botox generally provides the best results in patients with features of primary axillary hyperhidrosis.
A better response may be seen when:
Underarm Botox is not an ideal treatment for widespread sweating affecting the entire body. In generalised sweating, secondary causes should first be investigated.
In some people, Botox may not produce as strong or long-lasting an effect as expected.
A more limited response may occur when:
If the effect seems insufficient, treatment should not immediately be considered a failure. The treatment area, dose, diagnosis, and injection technique should be reassessed.
Underarm Botox is not directly an odour treatment. However, because it reduces sweat production, it may help decrease moisture under the arms and indirectly reduce bad odour.
Sweat itself often does not have a strong smell. Odour develops when sweat interacts with bacteria on the skin.
After Botox:
However, Botox alone may not be sufficient if bad odour is related to:
Yes. One of the most noticeable benefits of underarm Botox is reduction in wet patches and sweat marks on clothing.
When treatment is effective, the person may:
Clothing wetness may decrease but not always disappear completely. Normal sweating may continue, especially in very hot weather or during intense exercise.
No. Botulinum toxin does not destroy the sweat glands.
Botox temporarily reduces the nerve signals reaching the sweat glands. As the effect of the medication wears off, nerve endings may release acetylcholine again and the sweat glands may resume activity.
Treatments that permanently target the sweat glands work differently. Microwave thermolysis and certain surgical or energy-based methods aim to create a more permanent effect on the sweat glands.
The temporary nature of Botox may seem like a disadvantage, but some patients prefer it because it is a non-surgical, reversible, and local option.
Sweat glands in the underarm area make up only a small portion of the body’s total sweat glands. Reducing sweating only in the underarms therefore usually does not eliminate the body’s overall ability to regulate temperature.
Sweat glands in other areas of the body continue to function.
However, the following people should discuss their situation with their doctor before treatment:
Underarm Botox does not stop sweating throughout the body. However, as with every treatment, lifestyle and general health should be assessed.
Botox does not cut sympathetic nerve pathways in the way endoscopic thoracic sympathetic surgery does. For this reason, the classic compensatory sweating seen after surgery is not an expected main side effect of Botox.
However, once the underarm area becomes dry, the person may become more aware of normal sweating in other body areas. This does not always mean that sweating has truly increased.
If significant and uncomfortable sweating begins after Botox in areas such as the trunk, back, face, or groin, the situation should be reassessed. Sometimes an underlying cause or previously unnoticed generalised sweating becomes more apparent during this period.
Underarm Botox is applied by injecting botulinum toxin in small doses into the underarm skin.
The procedure may generally involve the following steps:
Underarm Botox usually does not require hospital admission. The person can generally return to daily life on the same day.
The iodine-starch test is not a medication that directly increases the effect of treatment. However, it may help show the active sweating area more clearly.
During the test, sweating areas become darker. This allows the doctor to plan injection points according to the areas where sweating is most intense.
The iodine-starch test may be particularly useful when:
Correct identification of the treatment area may contribute to a more even result.
Underarm Botox is tolerated by most people. Compared with the palms and soles, the underarm area is a less painful injection site.
Multiple small injections are made during the procedure. The level of discomfort may vary according to:
Cold application, topical anaesthetic cream, or vibration may be used to reduce discomfort. General anaesthesia is not required in most patients.
Extensive blood testing may not be required in otherwise healthy people with typical features of primary axillary hyperhidrosis solely because Botox is planned.
However, evaluation for secondary causes may be needed if sweating:
Depending on the patient’s symptoms, tests may include:
Not every patient needs all of these tests. Investigations are selected according to the medical history.
Before the procedure, the patient’s health status and medications should be assessed.
The doctor should be informed about:
Blood-thinning medications should not be stopped without medical advice solely to reduce the risk of bruising.
The doctor’s post-procedure instructions should be followed.
In general:
Because the underarm area moves frequently and is exposed to friction, post-procedure care is important.
When deodorant or antiperspirant use can be restarted after underarm Botox should be determined according to the treating doctor’s recommendation.
Immediately after the procedure, it may be necessary to avoid perfumed, alcohol-containing, or irritating products to prevent irritation of the injection sites.
Some people notice that they need less deodorant once sweating decreases. However, Botox is not directly an odour treatment. If odour continues, skin hygiene, product selection, and bacterial causes should be assessed separately.
Intense exercise may increase body temperature and blood circulation. Heavy exercise may therefore be discouraged on the day of the procedure.
Light daily activities are usually not a problem for most people. However, the doctor’s recommended waiting period should be followed for:
Return to normal activity depends on the sensitivity of the treatment area and the patient’s general condition.
Underarm Botox is generally well tolerated. However, as with any injection procedure, some side effects may occur.
Possible side effects include:
Most of these effects are mild and temporary.
Increasing redness, warmth, discharge, or severe pain at the injection site may require evaluation for infection.
The risk of significant muscle weakness is lower with underarm Botox than with hand Botox. This is because the injection is placed into or just beneath the skin and the target is the sweat glands.
However, temporary tenderness in nearby tissues or discomfort with shoulder or arm movements may occur.
The doctor should be contacted if unexpected arm weakness, generalised muscle weakness, or movement limitation develops.
Product information for botulinum toxin includes serious warnings about the possible spread of toxin effects beyond the injection area.
Although serious systemic spread is very rare after hyperhidrosis treatment at appropriate doses, urgent medical assessment is required if the following symptoms develop:
These symptoms may appear hours or days after treatment.
For safety, the procedure should be performed in a medical setting using approved products by physicians experienced in botulinum toxin treatment.
Botulinum toxin may not be suitable for some people.
Treatment may not be performed in the following situations:
Some situations may not be absolute barriers but require detailed assessment.
The doctor should be informed before treatment if any of the following are present:
This information is important for dose, timing, and treatment safety.
Safety data regarding botulinum toxin use for hyperhidrosis during pregnancy and breastfeeding are limited.
Because underarm sweating is generally not an emergency condition, treatment is usually postponed during pregnancy.
During breastfeeding, the decision should be based on:
Anyone who may be pregnant or is breastfeeding should inform their doctor before the procedure.
Underarm hyperhidrosis may become noticeable during adolescence and affect school life.
The age limit and approval status of botulinum toxin for hyperhidrosis vary according to the product and country.
In children and adolescents, the following should first be assessed:
Treatment decisions in children and adolescents should be made by physicians experienced in hyperhidrosis.
No. Underarm Botox is not permanent.
Botulinum toxin temporarily reduces acetylcholine release from nerve endings. Over time, nerve-to-sweat gland communication becomes stronger again and sweating returns.
Different treatments may be considered for patients seeking permanent or longer-lasting results. However, more permanent methods also have their own risks, costs, and patient selection requirements.
Although temporary effect may seem like a disadvantage for some patients, others may prefer Botox because it is reversible and non-surgical.
Repeated botulinum toxin treatments may be used in many patients when applied at appropriate intervals and doses.
However, each repeat treatment should reassess:
Unnecessarily early and uncontrolled repeat applications are not appropriate.
Rarely, an immune response against botulinum toxin may develop and reduce treatment effect. If the duration of effect becomes noticeably shorter, the cause should be evaluated by the doctor.
If the expected response is not achieved after underarm Botox, the cause should first be investigated.
Possible reasons include:
If sweating continues in a small area, additional treatment may be considered.
If the overall response is insufficient, the following may be reassessed:
Antiperspirants are applied to the skin surface and temporarily block sweat ducts, reducing the amount of sweat reaching the skin.
Botulinum toxin is injected and temporarily reduces the nerve signals reaching the sweat glands.
Antiperspirants:
Underarm Botox:
Botox is usually considered when topical products do not provide sufficient benefit.
Some prescription topical anticholinergic wipes or gels may be used for underarm hyperhidrosis. These products are applied to the skin to reduce sweat gland activity.
Topical medications:
Botulinum toxin:
The most suitable method depends on sweating severity, skin tolerance, patient adherence, and previous treatments.
Microwave thermolysis is a treatment that targets sweat glands in the underarm area using heat energy.
Microwave thermolysis:
Botulinum toxin:
Microwave thermolysis may be considered for patients seeking a near-permanent effect. However, it is not the most suitable option for every patient.
Some surgical or surgery-adjacent methods for underarm sweating aim to remove, scrape, or damage the sweat glands. Endoscopic thoracic sympathetic surgery targets the sympathetic nerve pathways.
Botox:
Surgical methods:
Surgery should not be chosen hastily only because Botox is temporary. Sweating severity, response to other treatments, expectations, and risks should be evaluated together.
Many patients who obtain sufficient benefit from underarm Botox and accept repeat treatment may not need surgery.
However, some people may:
Other treatment options may then be considered.
If Botox is effective, surgery may not be necessary. However, if Botox is ineffective, this does not automatically mean that surgery must be performed.
With appropriate patient selection, the correct product, suitable dose, proper injection technique, and application in a medical setting, underarm Botox can generally be a safe treatment.
Safety is influenced by:
Botox should not be treated as a simple cosmetic procedure. It is a prescription medication administered by injection.
Underarm Botox should be performed by physicians experienced in diagnosing hyperhidrosis and administering botulinum toxin.
The initial assessment may be performed by:
Botulinum toxin treatment is commonly performed by dermatologists.
If surgical treatment is being considered for primary hyperhidrosis, the patient may be evaluated by a thoracic surgeon.
Medical evaluation may be appropriate when:
When sweating begins suddenly, continues at night, or occurs with systemic symptoms, underlying causes should be evaluated before Botox treatment.
Botox treatment for underarm sweating is a non-surgical method that can provide strong improvement in primary axillary hyperhidrosis. It temporarily reduces nerve stimulation reaching the sweat glands and suppresses sweat production in the treated underarm area.
In suitable patients, clothing wetness, the need to hide the underarms, deodorant use, and social anxiety may decrease significantly. However, the treatment does not produce the same result in every patient and does not always stop sweating completely.
The effect usually begins during the first few days, becomes more noticeable within 7 to 10 days, and continues for several months in most people. As the effect decreases, sweating may return gradually, and repeat treatment may be performed in suitable patients.
Underarm Botox does not permanently destroy the sweat glands. It is therefore not a permanent treatment. However, it may be considered a non-surgical, local, reversible, and generally well-tolerated option.
Side effects are usually limited to injection-site pain, bruising, tenderness, and temporary discomfort. Serious systemic side effects are rare, but urgent medical evaluation is required if symptoms such as difficulty swallowing, speaking, or breathing occur.
Before treatment, it should be determined whether sweating is primary or secondary. Necessary evaluation should be performed for thyroid disease, blood glucose abnormalities, infection, medication use, or hormonal causes.
For the best outcome, treatment should be planned individually according to the patient’s sweating area, severity, previous treatments, expectations, and general health.
Yes. In suitable patients, underarm Botox can significantly reduce sweating. Clothing wetness, sweat marks, and social discomfort often decrease. However, the effect varies from person to person.
In some people, the underarm area may become almost completely dry. In others, sweating does not stop completely but decreases to a level that no longer affects daily life.
A reduction in sweating may begin within the first few days. In most people, the effect becomes more noticeable within 7 to 10 days. Full assessment may take approximately two weeks.
The effect varies between individuals but may generally continue for 3 to 10 months. Treatment may be repeated in suitable patients when sweating returns.
Botox is not directly an odour treatment. However, because it reduces sweat production, it may reduce underarm moisture and odour related to sweating. If odour continues, other causes should be assessed.
Underarm Botox is tolerated by most people. Fine needles are used. When necessary, cold application or topical anaesthetic products may reduce discomfort.
Botox does not cut the sympathetic nerves, so classic compensatory sweating seen after surgery is not an expected main side effect. Normal sweating continues in untreated areas.
No. The effect of Botox is temporary. The sweat glands are not destroyed. As the effect wears off, nerve-to-sweat gland communication becomes stronger again and sweating may return.
Antiperspirants may be sufficient for mild and moderate sweating. In severe primary underarm sweating, especially when topical products are insufficient, Botox may provide a more noticeable and longer-lasting reduction.
The procedure should be performed by a doctor experienced in hyperhidrosis and botulinum toxin. Underarm Botox is commonly performed by dermatologists. Surgical options, when needed, may be evaluated by a thoracic surgeon.