We are familiar with the fact that botulinum toxin A (Botox) works to soften lines associated with aging when placed in the muscle. What’s cool is that this same medicine can treat hyperhidrosis, or excess sweating, particularly of the under arm area, palms of hands, and soles of the feet. In this application, the medicine is hyper diluted and placed more superficially in the skin (rather than the muscle) in order to inhibit the sweat glands. This method of injection (hyper diluted and superficial placement) is termed microtox. 

A typical dosage for the treatment of underarm hyperhidrosis is 50 units per arm; we start with 35 units and incrementally increase until we get results. It is possible for one underarm to require a different dose from the other for relief. We are all different, and it’s ideal to use the least amount of medicine to achieve results, balancing cost and being conscious to not frivolously use medicine. Once the dose is dialed in, treatment need only be applied 1-2 times per year because results last about 6-9 months with improvement seen within the first week after treatment. 

Injecting into the underarms is less risky because we are not aiming for an aesthetic result, however it is technical nonetheless. To ensure that we are injecting the areas that yield results, it's prudent to employ a starch-iodine test. Here we apply iodine to the underarm, let it dry, then powder starch over the iodine and the combination yields a dark blue coloring wherever excessive sweating occurs. I have learned through experience that this test cannot be bypassed. 

To ensure comfort, the area is numbed for 20 minutes prior to treatment. After, we  identify where to treat with the starch-iodine test, then microtox the Botox.

Botox for hyperhidrosis of the underarm is considered when treatment with antiperspirant deodorant fails to offer relief and you’re not open to surgery. Research shows that underarm microtox injections can offer a 75% reduction in sweating, improvement in emotional and physical well being, and a decrease in activity limitations without adverse events (1). This microtox technique can also be applied to the palms of hands and feet. Further, a notable side effect of the aesthetic Botox application is that clients experience less sweating where the tox is placed, most notably in the forehead.

For most, microtox for hyperhidrosis is a safe, rapid, and effective option for treatment. This is an accessible treatment with potential for improved self-confidence and comfort. I offer complimentary consultations to see if you are a candidate for treatment. 

Thanks for reading, 
Heather