Underarm sweating treatment is also described as treatment for axillary hyperhidrosis or excessive underarm sweating. Botulinum toxin is one of the available options. As sweating does not always have the same cause, primary focal sweating must be distinguished from sweating related to another condition before treatment.
What is excessive underarm sweating?
Sweating is a normal function that helps regulate body temperature. Sweating that is too heavy to be explained by heat or exercise, soaks clothing and affects everyday life may be considered hyperhidrosis.
Axillary hyperhidrosis, or excessive underarm sweating, does not occur only in hot weather. It can affect work, social life and clothing choices. Its effect on daily life matters when deciding on treatment, as well as the amount of sweating.
How are primary and secondary sweating distinguished?
Primary focal hyperhidrosis is excessive sweating without another identifiable underlying illness. It usually affects particular areas, often on both sides, may have been present since a young age and can run in families.
Sweating that starts recently, affects the whole body or becomes prominent during sleep may require a different assessment. Possible causes include medicines, thyroid or blood sugar disorders, infections and hormonal changes.
Night sweats accompanied by fever, unexplained weight loss or other new symptoms require medical assessment first. The same tests are not needed for everyone; investigations depend on the history and examination. Do not stop prescribed medication yourself.
What do I assess before sweating treatment?
I ask when sweating started, how often it occurs, whether both underarms are similarly affected, whether other areas sweat excessively and whether clothing changes are needed. Antiperspirants already tried, the response to them, skin sensitivity and previous treatments influence the plan.
Infection, an open wound, irritation, painful nodules, discharge or a lump should be assessed first. Not every underarm symptom is caused by overactive sweat glands.
A starch–iodine test or similar method may be used when needed to map the sweating area. Testing is not compulsory for every patient; the treatment area is planned following an individual examination.
Please report the dates and areas of previous botulinum toxin treatments and, if known, the product used. Medical conditions, allergies, medicines and supplements are also reviewed.
How does underarm botulinum toxin reduce sweating?
Botulinum toxin temporarily reduces the release of the chemical signal from nerve endings that stimulates sweat production. In sweating treatment, the target is the signal to the sweat glands; weakening a muscle is not the aim.
Injections are placed within the skin. They do not surgically remove sweat glands, destroy them with heat or physically block sweat ducts. The effect can fade over time, so treatment is not presented as permanent.
The aim is to reduce excessive sweating so that it interferes less with daily life. Complete dryness, the same degree of improvement or the same duration cannot be promised for everyone.
Who may be considered for underarm botulinum toxin?
Treatment may be considered for focal underarm sweating that significantly affects daily life when appropriate antiperspirants have not provided enough benefit or cannot be tolerated. The cause of sweating and simpler options are considered first.
Some botulinum toxin products have a licensed indication for axillary hyperhidrosis that is resistant to topical treatment. Age restrictions, indication, dose and retreatment interval must be checked against the current information for the selected product. A product being authorised does not mean the same treatment can be used in every body area.
Treatment is not performed in patients with a known allergy to the product and is postponed if there is an active infection at the injection site. I postpone elective treatment during pregnancy and breastfeeding. Sweating in children and adolescents should not be managed on the basis of this adult information page.
How is underarm botulinum toxin performed?
After assessment and planning, the area is cleaned. Small amounts are injected into the skin of the sweating area using fine needles. The area and amount used are determined individually.
Several needle insertions are needed. Stinging, burning, tenderness or pinpoint bleeding can occur; treatment cannot be described as completely painless. In my general botulinum toxin treatment practice, I do not use numbing cream.
The time needed depends on the size of the area and the assessment and marking required. Consultation, preparation and the assessment after treatment are separate from injection time. A fixed number of minutes or units is not given for every patient.
Why do units, products and previous treatments matter?
The dose is determined by the extent of the sweating area, symptom severity, previous response, product characteristics and health status. A higher dose does not always mean a better or longer-lasting effect.
Units of different botulinum toxin products are not directly interchangeable. The previous product, total amount, treatment date and injections into other areas during the same period must be considered.
This page does not recommend an individual dose or injection points. Appropriate sourcing, storage and records for an authorised medicine matter; these do not completely eliminate the possibility of serious adverse effects.
When does treatment work, and how long does it last?
The effect is not immediate. Sweating may begin to decrease over the first few days and is often noticeably reduced within the first one to two weeks. In my botulinum toxin protocol, I plan the first review at 10–15 days.
The effect generally lasts several months. Approximately six months may be expected after underarm treatment, but it can be shorter or longer. The product, individual response and previous treatments influence the result.
Controlled studies have demonstrated reductions in sweating and its impact on daily life. Average or median durations reported in studies do not guarantee an individual result. Sweating can increase again as the effect wears off.
How are review and repeat treatment planned?
At review, I assess the areas still sweating, the response on each side, changes in daily life and any adverse effects. Residual sweating does not always mean more medicine is needed.
Repeat treatment is not determined by the calendar alone. The return of sweating, the previous product and amount, the treatment interval and health status are considered together. Unnecessarily frequent or high-dose treatment raises concerns about adverse effects and reduced response.
If treatment does not meet expectations, the reason is reassessed first. Permanent improvement after a set number of sessions or the same duration after every treatment cannot be guaranteed.
Aftercare following underarm sweating treatment
If you feel well, you can return to light everyday activities after treatment. Redness, tenderness or bruising may occur at injection sites; a reduction in sweating takes time.
In my botulinum toxin aftercare protocol, I ask patients not to shower on the day of treatment and to avoid strenuous exercise, hammam and sauna for the first week. I advise against rubbing or massaging the area and recommend avoiding significant pressure.
Do not apply deodorant or antiperspirant while injection sites are irritated. Do not schedule shaving, waxing or laser hair removal on the treatment day; when to resume depends on the condition of the skin.
Contact your doctor for increasing pain, hot red skin, discharge, generalised weakness or unusual symptoms. Do not wait for a routine review if you have difficulty swallowing, speaking or breathing.
Are sweating and underarm odour treated in the same way?
Deodorants mainly target odour, whereas antiperspirants aim to reduce the amount of sweat; some products combine both. Odour and wetness are different concerns.
The composition of sweat, microorganisms on the skin and other skin conditions can contribute to underarm odour. Odour may persist even when botulinum toxin reduces wetness; complete or permanent elimination of odour cannot be promised.
Painful swelling, recurrent nodules, discharge or significant skin changes should not be addressed solely with deodorant or sweating injections. A diagnosis is needed first.
Other options for excessive sweating
For mild symptoms, observation, suitable clothing and antiperspirants may be sufficient. Topical treatments such as antiperspirants containing aluminium salts can be considered, although they may irritate the skin. Using deodorant does not necessarily mean an adequate antiperspirant treatment has been tried.
Prescription medicines applied to the skin or taken by mouth may be considered for suitable patients. They have their own risks, including dry mouth and problems with vision, urination or cooling the body in hot conditions. They should not be started without medical advice.
Iontophoresis is used particularly for sweating of the hands and feet; its suitability and effectiveness for underarms require separate assessment. Devices that target sweat glands or limited surgical procedures may also be considered in selected cases. Their scope, risks and availability differ.
Sympathectomy is an operation on the nervous system and is different from botulinum toxin treatment. It requires careful patient selection because of significant risks, including compensatory sweating. Where another condition causes sweating, treating the underlying cause takes priority.
Risks and unwanted outcomes of underarm botulinum toxin
Every medical intervention, procedure and operation carries risks. Depending on the treatment and the individual's health, death, disability and temporary or permanent unwanted functional and/or aesthetic outcomes may occur.
No medical intervention, procedure or operation guarantees the result or results a patient wishes to achieve.
Risks differ in frequency and severity. Temporary injection-site symptoms and serious systemic effects require different consideration. The product, amount, treatment area and individual health are important; adverse-effect percentages from other treatment areas should not be directly applied to this procedure.
Needle and injection-site risks
- Pain and tenderness. Stinging, burning, pain, itching, redness or swelling may occur.
- Bleeding and bruising. Pinpoint bleeding, bruising or a collection of blood may occur. Conditions that affect bleeding need particular consideration.
- Infection. Painful redness, warmth or infection may develop. Additional treatment may be required; a severe infection can cause permanent scarring or tissue problems.
- Dizziness and fainting. Needle insertion or anxiety about treatment can cause dizziness or fainting.
Altered sensation and local weakness
- Numbness or altered sensation. Numbness, tingling or unusual sensitivity may occur in the area. Persistent or worsening symptoms should be assessed.
- Muscle weakness. Effects on nearby muscles can cause local weakness or discomfort with arm movement; this may last longer than expected.
- General symptoms. Headache, nausea, tiredness, muscle aches or dry mouth may occur.
Unwanted changes in sweating
- Insufficient or uneven reduction. Sweating may not decrease as much as expected. Differences between sides or areas of residual sweating can remain.
- Dryness and skin discomfort. More dryness than expected, sensitivity or skin discomfort may occur.
- Increased sweating elsewhere. Increased sweating in other parts of the body has been reported. This possibility should not be dismissed; a noticeable increase should be assessed.
- Persistent odour. A reduction in sweating does not mean odour will improve to the same extent.
Allergy and severe hypersensitivity
- Allergic reaction. The medicine or its other ingredients may cause itching, a rash, hives or swelling.
- Anaphylaxis. Swelling of the tongue or throat, breathing problems or circulatory collapse can occur. Emergency intervention and hospital treatment may be required; the reaction can be fatal.
Spread of the effect beyond the treatment area
- Generalised muscle weakness. Botulinum toxin effects can cause symptoms beyond the intended area and a serious botulism-like illness.
- Swallowing, speech and vision problems. Difficulty swallowing, slurred speech, voice changes, double vision or marked eyelid drooping can develop.
- Breathing problems and aspiration. Difficulty breathing, food or liquid entering the airway, pneumonia or respiratory failure can occur. Intensive care and breathing support may be needed.
- Permanent harm and death. Serious reactions can cause permanent loss of function, disability or death. Using an authorised product does not reduce the risk to zero.
- Delayed onset. Symptoms need not start immediately; they may develop hours, days or weeks after treatment.
Repeat treatment, inadequate response and additional care
- A short-lived or reduced effect. The response may last less time than expected, be absent or decrease with repeated treatment. An immune response is only one possible explanation.
- Further treatment. Reassessment, further injections, a different treatment or hospital care may be needed. These also carry risks and costs.
- Limits to immediate reversal. There is no routine method that immediately removes the medicine's effect in the way a filler can be dissolved. Management depends on the symptoms; serious symptoms must not be left to resolve on their own.
- No guarantee of results. Complete dryness, a particular duration or the desired functional and aesthetic result cannot be guaranteed. Unwanted outcomes may be temporary or permanent.
Do not wait if swallowing, speech or breathing becomes difficult
Difficulty swallowing, slurred speech, voice changes, generalised muscle weakness or difficulty breathing after botulinum toxin treatment requires urgent medical assessment. Symptoms can start days or weeks later; do not wait for a routine review or for the effect to wear off.
Call 112 for breathlessness, significant swallowing difficulty, tongue or throat swelling, or rapid deterioration. Tell the medical team the treatment date, areas injected and product name, if known. Do not drive yourself if your vision or muscle strength is affected.
This information does not replace an individual examination, verbal explanation or the informed consent discussion before treatment. Other unforeseen or individual risks may exist. Reading this page does not mean consent has been given to the procedure.
Frequently asked questions about underarm sweating treatment
What is botulinum toxin for underarm sweating?
Botulinum toxin is injected into sweating underarm skin to temporarily reduce the nerve signals that stimulate sweat glands. It does not remove or destroy the glands.
Why do my underarms sweat so much?
The cause may be primary focal hyperhidrosis or sweating related to medicines or another condition. Assessment considers when it began, how widespread it is, night-time symptoms and medical history.
Is my sweating caused by stress?
Stress can increase sweating, but excessive sweating cannot always be explained by stress alone. The pattern of symptoms and other possible causes are considered together.
Can sweating in winter or a cool room be hyperhidrosis?
Yes. Focal excessive sweating does not occur only in hot weather. Sweating that is unrelated to temperature and affects everyday life should be assessed.
Can underarm botulinum toxin be used for night sweats?
The cause of night sweats should be assessed first, particularly if they are new or accompanied by fever or weight loss. They should not be addressed simply by proceeding to injections.
Are deodorants and antiperspirants the same?
No. Deodorants mainly target odour; antiperspirants target the amount of sweat. Some products contain both. Using deodorant alone does not mean an adequate sweating treatment has been tried.
Is botulinum toxin the first treatment for excessive sweating?
It is not the first option for every patient. Appropriate antiperspirants, everyday measures and the cause of sweating are considered. Injections may be considered when these treatments have not helped enough or cannot be tolerated.
When does underarm botulinum toxin start working?
Sweating may start to decrease over the first few days and is often noticeably reduced within the first one to two weeks. In my protocol, the first review is at 10–15 days.
Will my sweating stop completely?
A substantial reduction is possible, but complete dryness, exactly the same response on both sides or a total end to sweating cannot be guaranteed.
How long does botulinum toxin for underarm sweating last?
The effect generally lasts several months. It may last approximately six months, but can be shorter or longer depending on the individual response, product and previous treatments.
Is underarm botulinum toxin permanent?
No. The effect of botulinum toxin is temporary. It does not permanently destroy sweat glands; the need for repeat treatment is assessed individually.
Can I return to everyday activities after treatment?
If you feel well, you can return to light daily activities. Injection sites may be tender or bruised; advice about exercise and hot environments still applies.
Are the injections painful, and do you use numbing cream?
Several fine needle insertions may cause stinging or burning. In my general botulinum toxin treatment practice, I do not use numbing cream. A painless treatment cannot be guaranteed.
How many units are needed for underarm sweating?
The amount depends on the area, severity, product and previous response. Units of different products are not directly interchangeable; one fixed amount is not used for everyone.
Is a starch–iodine test essential?
It is not compulsory for every patient. It is one method that may be used when the sweating area needs to be mapped more clearly.
Can just one underarm be treated?
Symptoms and examination findings on both sides are assessed. New or pronounced one-sided sweating or swelling should have its cause investigated first.
Can I use deodorant after treatment?
Do not apply deodorant or antiperspirant while the injection sites are irritated. When to resume depends on skin recovery and your individual aftercare instructions.
When can I shower after underarm botulinum toxin?
In my botulinum toxin treatment protocol, I ask patients not to shower on the treatment day. Follow the individual instructions you are given.
When can I resume exercise, hammam and sauna?
I ask patients to avoid strenuous exercise, hammam and sauna for the first week. Light everyday activities are considered separately from strenuous exercise.
When can I shave, wax or have laser hair removal?
Do not schedule these on the treatment day. If the skin is irritated, wounded or infected, it needs to heal first. Timing is discussed during your assessment.
Does underarm botulinum toxin also remove odour?
Wetness may decrease without an equivalent change in odour. Other factors causing odour should be assessed; complete or permanent elimination cannot be promised.
Can sweating increase in other areas?
Increased sweating elsewhere has been reported. It does not necessarily occur in every patient; report any noticeable increase to your doctor.
Does reducing underarm sweating stop sweating throughout the body?
No. Treatment targets a limited area, while other areas continue to sweat. Sweat glands are not physically blocked. Individual health and risks still need assessment.
Can I have treatment if I have a lump or painful underarm swelling?
An examination is needed first. Lymph node, skin or other tissue problems are assessed separately from sweating treatment. An unexplained lump should not simply be injected with botulinum toxin.
Are sweaty hands and feet treated in the same way?
Assessment, dose, pain and the risk of muscle weakness differ between body areas. An underarm treatment plan should not automatically be applied to the hands or feet.
Can I have treatment during pregnancy or breastfeeding?
I postpone elective botulinum toxin treatment during these periods. Individual circumstances and medicines should be reviewed with a doctor.
Can men have botulinum toxin for excessive sweating?
Suitability is not determined by sex alone. The cause of sweating, its effect on daily life, health status and previous treatments are assessed.
Which illnesses and medicines should I disclose?
Report all medical conditions and medicines. Neuromuscular disorders, swallowing or breathing difficulties, previous toxin reactions, certain antibiotics and muscle relaxants are particularly important.
Should I stop my blood thinner?
Do not stop a prescribed medicine yourself. The risk of bruising and bleeding is considered alongside the risk of stopping the medicine; any change must be agreed with the prescribing doctor.
Which adverse effects require urgent help?
Difficulty swallowing, speaking or breathing, generalised weakness, tongue or throat swelling, or rapid deterioration requires urgent medical help. Symptoms can start days or weeks later.
Will I automatically receive a top-up at review?
A review does not automatically mean an additional dose. The sweating area, previous product and amount, interval, response and adverse effects are assessed.
Why do underarm sweating treatment costs vary?
The product, treatment area, individual amount, assessment and follow-up influence the cost. Comparing units or prices alone does not establish suitability or safety.
What affects the cost of underarm sweating treatment in Antalya?
When considering the cost of underarm botulinum toxin or excessive sweating treatment in Antalya, the product, size of the area, individual amount and follow-up plan are assessed together. Investigating another possible cause or the need for a different treatment is considered separately.
The pattern of sweating and an appropriate treatment should be identified before comparing prices. An individual plan, expected benefits and possible risks are explained after examination.
References
This original patient information text draws on relevant information from our existing botulinum toxin page, sweating treatment and risk information in the consent form supplied by the doctor, controlled studies and institutional patient information.
Review at 10–15 days, the general preference not to use numbing cream for botulinum toxin treatment and the aftercare instructions reflect Dr Onur Serin's clinical practice. An approximately six-month effect is not an individual guarantee. Medicine information must be considered alongside the current patient information leaflet for the selected product. Sources reviewed and last updated: 27 October 2026.
- Botulinum Toxin Treatment Patient Information and Consent Form — sweating treatment and relevant risk information from the copy supplied by the doctor; 25 October 2026.
- American Academy of Dermatology — Hyperhidrosis: Diagnosis and Treatment. ↗
- British Association of Dermatologists — Hyperhidrosis: Patient Information. ↗
- British Association of Dermatologists — Hyperhidrosis: Referral Management Guidance. ↗
- NHS — Excessive Sweating (Hyperhidrosis). ↗
- Naumann and Lowe — Botulinum toxin type A in treatment of bilateral primary axillary hyperhidrosis: randomised, parallel group, double blind, placebo controlled trial. BMJ (2001). ↗
- Lowe et al. — Botulinum toxin type A in the treatment of primary axillary hyperhidrosis: a 52-week multicenter double-blind, randomized, placebo-controlled study of efficacy and safety (2007). ↗
- MHRA — Botulinum toxin type A products: updated warnings regarding risk of iatrogenic botulism; 15 July 2026. ↗
- American Society of Plastic Surgeons — Botulinum Toxin: Risks and Safety. ↗
- American Academy of Dermatology — Botulinum Toxin Therapy: Preparation. ↗