What is Botox?

Botox is a medication that is used in the treatment of excessive sweating. Botox is actually a toxin that is produced by a bacteria known as Clostridium botulinum. The toxin functions by blocking the function of nerves. When the toxin is spread througout the body, paralysis will occur. When the toxin is injected into a specific site, however, only the nerves in that area will be paralyzed.

Botox Treatment for Excessive Palm Sweating (Palmar Hyperhidrosis)

Botox can be used to treat plantar hyperhidrosis. Botox treatment is effective for many individuals with sweaty feet. A study of botox for the treatment of palmar hyperhidrosis was completed on 19 individuals, where botox was given in one arm, while the other arm did not receive botox. All patients rated the Botox treatment a success. (1)

Botox for Excessive Underarm Sweating (Axillary Hyperhidrosis)

A recent study demonstrated that Botox is effective in treating sweaty underarms. (2) After four weeks, 75% of patients in the study noted a significant improvement in symptoms with Botox treatment.

Side Effects of Botox Treatment for Excessive Sweating

The main side effects of botox treatment include

• pain during the injection
• the high cost of botox
• the possiblility of temporary hand weakness.

Most patients find the hands and feet to be particularly painful during injection of botox. In addition, the botox treatment does not last indefinately, and has to be repeated. Temporary hand weakness was seen in 21% of patients in one study. (3)

Botox successfully treats axillary hyperhidrosis, and a new study reported in the January issue of the Archives of Dermatology suggests that bromhidrosis may be similarly treatable.

“Botulinum toxin A may foster favorable odorous substances by rebalancing apocrine and apoeccrine secretion patterns and/or preventing unpleasant smells of microbial degradation,” write Marc Heckmann, MD, from Ludwig-Maximilian-University in Munich, Germany, and colleagues.

In this randomized, double-blinded study, 16 healthy subjects (average age, 27 years) were injected with 100 U botulinum toxin A in one axilla and with 0.9% sodium chloride solution in the other axilla. At baseline and at seven days after treatment, subjects assessed their own body odor and that of the other subjects by sniffing patches cut from the armpit sections of T-shirts worn for 24 hours. They rated odor intensity from 0 for no odor to 6 for the most intense odor, and emotional valence of the odor from -3 for most unpleasant to +3 for most pleasant.

Mean rating for intensity of body odor was 2.69 before treatment, 2.9 seven days after sodium chloride injection, and 1.83 seven days after botulinum toxin A injection ( P = .02). Subjects also reported that the botulinum toxin A-injected axilla was markedly dry compared with the control axilla. Odors of the botulinum toxin A-treated axillae were rated as being more pleasant than those emanating from the control axillae (mean rating, 0.46 vs. -1.14; P = .01).

“Axillary injection of botulinum toxin A can significantly ameliorate the intensity and improve the quality of body odor,” the authors write. “The underlying mechanisms may include interference with skin microbes and denervation of apoeccrine sweat glands, but this remains to be further investigated.”

Arch Dermatol. 2003;139(1):57-59