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Do you Suffer from Excess Local Sweating? (Focal Hyperhidrosis)?

  • Which drips and embarrasses
  • Which requires clothing  changes
  • Which leaves wet marks, limits colours, and stains
  • Which leaves wetness on ink, paper, and computers
  • Which affects  hand shaking, interviews, fine dexterity
  • Which messes hair style, smears glasses, and stings eyes
  • Which imprints floors, slips in sandals and on marble tiles
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Botulinum Toxin A (Botox Therapeutic by Allergan)

Botox has revolutionized sweat treatment.—especially of the underarms.


Vials of Botox Therapeutic

Underarms (axillae)

Botox injections work well for nearly all cases of underarm sweating. Most  achieve a 90% improvement and last  an average of 5-7months. Range 3-13. The Botox injected is identical to cosmetic Botox, but is named:-- Botox Therapeutic;---drug identification number (DIN)- 01981501. Before injecting, we apply iodine, and then cornstarch to the underarms. Sweating areas turn blue  and act as an injection guide. Please do not apply an anti-perspirant before the procedure. You may return immediately to  all activities. Botox has been used for underarms  since 1997 and there are no reports of side effects at these low doses. There can be mild injection bruises. Sweating in other areas  occurs normally as before. Beneficial effects show in 1 to 4 days, and are  maximum within a week. Deodorants can be used immediately. Botox is not approved for use in pregnancy or breast feeding, or in individuals with myasthenia gravis or similar neurological problems. Can be used in older children, teens, and adults. Most patients do not require it, but if your skin is sensitive, then an icepack is applied. You can also pre-apply a numbing agent such as:-- EMLA, Benzocaine gel, Maxilene, or Xylocaine gel 2%.

One vial of Botox contains 100 units and costs about $435 plus dispensing fee (2 vials a bit less). For small underarms, one vial does both sides. Larger underarms and most men require 2 vials. Most private insurance plans cover Botox for hyperhidrosis  (OHIP does not). Prior authorization is often required and we provide an insurance form. We do not supply  Botox vials, but write a prescription for them. Neither OHIP or insurance companies cover our injection fees.  Our total injection fee for both under-arms is $225. No HST.

  • Wet shirt from sweatingWet shirt from sweating
  • A conclusive starch iodine testA conclusive starch iodine test
  • A moderate starch iodine testA moderate starch iodine test
  • Injecting Botox to underarmInjecting Botox to underarm


Botox is 90% effective for palmar sweating. One hundred units are given to each palm, but large men’s hands require 150. We use an ice pack, and then an innovative cool refrigerant; spray (about which we have written and lectured). This spray is applied to each injection site and is very helpful in reducing sensations. We perform the actual hand injection in under 2 minutes. With Botox injections of the palms, there can be temporary (weeks) unpredictable weakening of the  fine muscles, so this procedure should be performed carefully on individuals who utilize their hands for fine work (musicians, dentists etc.) or in those who perform  vigorous activities requiring strength.  Patients rarely may choose to treat only their worst hand. Our injection fee for 2 hands is $275. No HST. After 2 or 3 weeks, the occasional patient may require a 'top-up' with additional Botox. There is no charge for these injections.

  • Dripping palmsDripping palms
  • Dripping fingersDripping fingers
  • Ice pack on palmIce pack on palm
  • Injecting palms using cold sprayInjecting palms using cold spray



Botox injections are performed  as per hands and some do well, but satisfactory results are less consistent than with hands. We do not know why failures can occur

  • Dripping foot, wet floor, and stained shoeDripping foot, wet floor, and stained shoe
  • Injecting foot using cold spray numbingInjecting foot using cold spray numbing

Forehead & Scalp

Botox injections are  effective for  the upper forehead and  frontal scalp and  patients often continue with them. After Botox injections, the forehead may feel a bit tighter and occasionally there can be bruising that  lasts a few days. One vial is usually adequate. Try Secure pads first.

Pelvic area

Botox injections work well in the thigh creases. One vial adequate.

Chest, breasts and back

Botox is effective for sweating between, and under the breasts, and for the lower back

Frey’s Syndrome

Also called-- auriculotemporal syndrome or gustatory sweating.   Can be a side effect of parotid surgery, but  can also develop spontaneously. There may be flushing and/or sweating when eating.  Botox treatment has been reported by several authors to be effective.

Please try to locate  the exact  source of your sweating in order that Botox can be administered more precisely.

Please note that our injection fees are not covered by insurance companies.