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Excessive Sweating (Hyperhidrosis): Botulinum Toxin for Underarm, Hand and Foot Sweating
What hyperhidrosis is, primary vs secondary sweating, botulinum toxin for underarms, palms and soles, duration, side effects and other treatment options.
Sweating regulates temperature, but in hyperhidrosis it far exceeds the body's needs, affecting daily life, work and relationships.
| Feature | Primary | Secondary |
|---|---|---|
| Cause | No underlying disease | Another condition or medicine |
| Onset | Childhood or adolescence | Any age |
| Areas | Underarms, palms, soles, face (symmetrical) | Usually widespread |
| During sleep | Usually none | Night sweats possible |
| Family history | Common | Usually absent |
Night sweats, unexplained weight loss, fever or new widespread sweating need medical investigation.
Impact: visible sweat marks and frequent changes; avoiding handshakes, paper and keyboards; footwear problems, odour and skin infections; social anxiety.
How the toxin works: it temporarily reduces nerve signals to sweat glands, markedly reducing sweating in the treated area.
| Area | Notes |
|---|---|
| Underarms | Most common; relatively comfortable |
| Palms | More sensitive; extra comfort measures |
| Soles | Sensitive; variable duration |
| Forehead and scalp | Selected cases |
Process: assess type, areas and severity; map the sweatiest zone if needed (iodine-starch test); many small superficial injections; about 20–40 minutes.
| Time | What happens |
|---|---|
| Days 2–7 | Sweating decreases |
| Week 2 | Full effect |
| Months 4–12 | Gradual fading (by area and person) |
Effects are usually longer in underarms and more variable on palms and soles.
Side effects: mild pain and bruising; occasional temporary reduced grip strength with palm treatment; rarely a sense of increased sweating elsewhere.
Afterwards: no intense exercise or sauna that day; no waxing or shaving underarms on day one; no massage.
| Other options | Notes |
|---|---|
| Prescription antiperspirants | First step for mild–moderate |
| Iontophoresis | Especially hands and feet |
| Medicines | Selected cases, medical advice |
| Device-based treatments | For underarms |
| Surgery | Severe, unresponsive cases |
Not for: pregnancy and breastfeeding; certain neuromuscular diseases; active infection at the site.
At our Istanbul clinic hyperhidrosis is assessed by type and area, with botulinum toxin given by a doctor to suitable candidates; clients from Yalova, Bursa, Kocaeli and Gebze can plan before summer.
