People with hyperhidrosis don’t just sweat a lot. They endure an endless saga of soaked clothes, hard-to-hide odors and bottle after bottle of half-used “prescription-strength” antiperspirants that never seem to work.
What does seem to work, though, is getting Botox injections for sweating. Recently, more and more ex-sweaters have sung the praises of the 30-minute procedure’s knack at stopping the sweat for good (or at least, for several months).
In a 2018 study of people with hyperhidrosis, the majority of people found injections more successful than any other excessive sweating treatment, according to the Journal of Drugs in Dermatology.
Tiny Pricks, Big Difference
Wherever overactive sweat glands are — in the feet, palms or underarms — Botox injections can target them. And with about 20 small pricks across the sweat-prone surface area, it’s a quick, relatively painless process that has lasting (and for many, life-changing) results.
At least, so said Christine A. DiEdwardo, a board-certified plastic and reconstructive surgeon and the medical director of the Lahey Center for Cosmetic and Laser Surgery at Lahey Outpatient Center, Lexington.
“Patients are just devastated by hyperhidrosis, and for them, Botox does change their quality of life,” she said. “These are people who are constantly sweating through and staining their clothing or can’t take their coat off at work, so it really makes a difference.”
How It Works: Stopping the Sweat Messages
Botox works by stopping the messages your body sends to sweat glands. When the body feels the need to sweat, it tells the glands to sweat. But in people with hyperhidrosis, those messages can go haywire, triggering buckets of sweat when it’s not really needed.
That’s where Botox comes in. Through a grid-like series of small injections spaced about 1 centimeter apart, the procedure covers an entire sweat area in under a half hour. It usually takes about two weeks to take effect, but when it does, those “sweat now” messages stop.
While stopping those messages doesn’t stop the sweat completely, it dramatically reduces it at the site of every injection. All told, it lasts for about four to six months, even though everyone is different.
“It definitely varies from patient to patient,” Dr. DiEdwardo said. “The best candidates are people who have excessive sweating despite trying different prescription antiperspirants.”
How It Feels: Lighter Than a Bee Sting
Most people embarrassed by the curse of hyperhidrosis would happily go to great pains to get any excessive sweating treatment. But luckily, they don’t have to — because the procedure is relatively painless and hurts less than a bee sting (and certainly less than a tattoo).
“We use a special needle that’s extremely small, so most patients tolerate it because the injections only feel like tiny pinpricks,” Dr. DiEdwardo said. “Everyone’s pain tolerance is different, but if patients are super sensitive, we can place a temporary numbing cream that helps.” It also doesn’t leave any redness or swelling, she added.
Paying for Treatment
For many people, the most painful part isn’t about the pricks themselves. It’s paying for them.
“Normally, someone’s primary care doctor would be referring them, usually writing a letter to the insurance provider to get preapproval,” Dr. DiEdwardo said, adding that out-of-pocket costs can range from $1,000 to $2,000 per treatment. “Typically, you’d need to be diagnosed with hyperhidrosis and show medical necessity.”
That proof of medical necessity can be a challenge because it varies by insurance provider. The International Hyperhidrosis Society offers insurance and reimbursement educational resources for people seeking excessive sweating treatment, plus a sample letter of medical necessity.
Living a Drier Life
Luckily, for the 365 million people dealing with excessive sweating, according to the International Hyperhidrosis Society, there are options beyond hiding under oversized coats or packing an extra change of clothes for work.
If that sounds like you, start with prescription antiperspirants, and if the sweat continues, maybe Botox could save your life — and your wardrobe, too.
Do you think you might be a candidate for Botox injections for sweating? Find a plastic and reconstructive surgery doctor near you.