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Botox®: A New Hope for Excessive Underarm Sweating


A recent study conducted at the University of California San Francisco has uncovered a highly effective treatment for excessive underarm sweating, also known as axillary hyperhidrosis, utilizing botulinum A neurotoxin, commonly known as Botox®.

Dr. Richard Glogau, a clinical professor of dermatology at UCSF, described the breakthrough as offering patients afflicted by this condition a significant alternative to surgery. He highlighted that this treatment can be administered during a regular office visit, doesn’t require anesthesia, and offers long-lasting relief from sweating.

The study’s findings were published in the September issue of Dermatologic Surgery.

Excessive underarm sweating, or axillary hyperhidrosis, is typically triggered by the overstimulation of sweat glands through autonomic nerves. As Dr. Glogau pointed out, this condition can lead to substantial emotional distress, social stigma, and additional costs associated with clothing maintenance and cleaning.

Historically, traditional treatments included the use of over-the-counter commercial antiperspirants, oral medications like anticholinergic drugs, a method called tap water iontophoresis, and, as a last resort, surgery. Dr. Glogau noted that existing non-surgical treatments have had limited effectiveness in addressing excessive sweating and often led to unpleasant side effects.

Surgical intervention for underarm sweating can be effective; however, it carries the risk of completely inhibiting sweating in other parts of the body, such as the upper chest, arms, and neck. This can result in compensatory hyperhidrosis, where other body parts start to sweat excessively. Additionally, surgery poses a risk of infection and has a failure rate of two to five percent.

In this recent study, patients with excessive underarm sweating received Botox® injections. Despite being toxic in high doses, Botox® has found medical use in diluted amounts to treat various conditions, including uncontrolled eye twitching, crossed eyes, muscle spasms, and, more recently, facial wrinkles and frown lines. When used to address sweating, Botox® works by blocking the release of acetylcholine, a chemical that stimulates the sweat glands.

The study involved twelve patients (four males and eight females) who received Botox® injections directly in their underarms. The dosage used was similar to that employed for wrinkle and frown line treatment. Patients were evaluated one week and one month post-injection and were instructed to return when they noticed a recurrence of sweating.

All patients reported a reduction in underarm sweating within 48 hours of the treatment. The dryness in the underarms lasted between four to seven months, with an average of 5.2 months. Subsequent Botox® reinjections produced similar results, and further follow-up indicated that the treatment remained effective for a duration of five to twelve months. Importantly, compensatory hyperhidrosis and other side effects were not reported.

However, one major drawback of this treatment is its cost, as Dr. Glogau noted. Depending on the amount of Botox® required, the expenses typically range from $700 to $1000, and the treatment needs to be repeated at least once a year.