ZocdocAnswersHi, I have excessive axillary hyperhidrosis. Will botox eliminate my sweating?

Question

Hi, I have excessive axillary hyperhidrosis. Will botox eliminate my sweating?

I've tried topical agents which didn't work and anticholinergics which caused bad side effects like dry mouth, constipation, blurred vision. I would like to try Botox for the armpits but I need it to completely eliminate my underarm sweating. I get nervous because I sweat and sweat because I'm nervous and tried tackling the anxiety with no ease.

Answer

Sorry to hear that you have been dealing with axillary hyperhidrosis and that the medications you have tried to date have not worked well for you. I would recommend making an appointment with a dermatologist, or a plastic surgeon. I am sure that you are aware that 'botox' is an injectable drug that was originally derived from a bacteria called Clostridium botulinum. It is a gram positive obligate anaerobe bacteria that secretes a toxin that causes flacid paralysis. Like many medical innovations, something that naturally occurs in nature is modified slightly and used for medicinal purposes. Medical grade botox prevents the pre-synaptic release of acetylcholine at nerve muscle junctions. Acetylcholine is a neurotransmitter that is used to send the signal to your muscles to tell them to contract. It is also the neurotransmitter in the skin at the junction of nerves with sweat glands. So injection of botox into and around muscle, will cause the muscle to be unable to contract by blocking the neural signal to it. In a similar fashion, injecting botox into skin that has a lot of sweat glands, sweating is decreased by blocking the neural signal that stimulates sweating. This however is not a permanent fix, as botox generally wears off anywhere between 3 months and 6 months after injection. If you are interested in botox for hyperhydrosis, I would recommend making an appointment with a dermatologist, or a plastic surgeon that does a lot of botox. Best of luck.

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