In 2004, the FDA approved BOTOX (onabotulinumtoxinA) for treating severe primary axillary hyperhidrosis, or excessive underarm sweating, in patients unresponsive to antiperspirants. Owned by AbbVie, Inc., BOTOX has become the most extensively studied botulinum toxin brand worldwide. Since its first FDA approval in 1989, it is now authorized to treat eight medical conditions in the United States. BOTOX has been successfully used to treat millions of patients with varying conditions, such as spasticity and movement disorders. Moreover, at least 20 countries have approved its use for treating excessive underarm sweating.
Understanding BOTOX and Its Mechanism
OnabotulinumtoxinA, a natural and purified protein, can temporarily block the secretion of the chemical responsible for activating the body’s sweat glands. BOTOX injections are administered just beneath the skin’s surface, where the medicine remains.
Proven Effectiveness in Treating Different Body Areas
Studies show that onabotulinumtoxinA is safe and effective in treating excessive sweating in areas like the armpits, hands, feet, head and face (craniofacial), and other smaller regions, such as beneath the breasts. For underarm excessive sweating, BOTOX has demonstrated an 82-87% decrease in perspiration. The results become noticeable within 2 to 4 days post-treatment, with full effects observed within 2 weeks. The dryness typically lasts 4 to 12 months, with some studies reporting durations of up to 14 months.
Benefits of Repeated BOTOX Treatments for Hyperhidrosis
Repeated BOTOX treatments have been found to be safe and effective for hyperhidrosis, providing significant, long-lasting improvements in patients’ symptoms, daily functioning, and quality of life . BOTOX has also been scientifically proven to enhance on-the-job productivity. While sweating is essential for temperature regulation, localized body areas contain only a small percentage of the body’s sweat glands, such as underarms, which house less than 2% of the body’s sweat glands. The temporary cessation of these sweat glands does not significantly impact thermoregulation. Compensatory sweating has not been identified as a concern.
Risks and Side Effects
Botox is generally considered safe for treating hyperhidrosis. However, some side effects and complications may occur, including:
- Temporary pain, swelling, or redness at the injection site
- Headache or flu-like symptoms
- Weakness in nearby muscles
- Dryness in non-treated areas
In rare cases, more severe complications may arise, such as difficulty swallowing, breathing, or speaking. Contact your healthcare provider immediately if you experience any of these symptoms.
BOTOX for Palmar, Craniofacial, and Plantar Hyperhidrosis
For palmar (hand) excessive sweating, BOTOX is 80-90% effective, although repeat injections are required after 6 months. Some patients may experience temporary pain and weakness in their hands. BOTOX works well for head and face sweating, but the injection technique demands expertise. Potential side effects include temporary facial asymmetry, which can be addressed with additional BOTOX injections if needed. In the case of plantar (foot) hyperhidrosis, BOTOX is less effective and may cause more pain during injections. Some patients report dissatisfaction with the results.
Maximizing BOTOX Treatment Efficacy
BOTOX treatments for hyperhidrosis are most effective when administered by a clinician experienced in the procedure and trained by the International Hyperhidrosis Society. Treatment can be done in a doctor’s office within a short period and does not require restrictions in work or leisure activities. Anesthetic techniques, such as nerve blocks, ice, or vibration analgesia, may be used to alleviate potential discomfort.
Cost and Duration of BOTOX Treatments
The cost of BOTOX treatments varies depending on the size of the treated area and insurance coverage availability. An approximate cost for treating both underarms is around $1,000. Although BOTOX injections do not provide a permanent cure for hyperhidrosis, symptoms gradually dissipate (usually within a week) and return over time. Follow-up injections may be necessary at intervals ranging from 7 to 16 months.
Comparison to Other Treatments
While Botulinum toxin is an effective treatment option for hyperhidrosis, it is essential to compare it to other available methods. For example, oral medications can provide relief for some patients, but they often come with side effects like dry mouth, blurred vision, and dizziness. On the other hand, iontophoresis is a non-invasive treatment that uses mild electrical currents to reduce sweating, with minimal side effects. This treatment method requires consistency and patience, as it typically takes several weeks of regular sessions to achieve noticeable results.
Another option to consider is surgical intervention, such as sympathectomy or sweat gland removal. These procedures can provide long-lasting relief from excessive sweating but come with inherent surgical risks and potential complications.
Each treatment has its benefits and drawbacks, and the most suitable option will vary depending on individual needs, preferences, and the severity of their condition.
In conclusion, BOTOX has proven to be an effective treatment for excessive sweating in various body areas. By seeking help from experienced healthcare providers and exploring available resources, you can take control of your hyperhidrosis and improve your quality of life.
