Excessive Sweating — Underarms, Palms and Soles

How the Treatment Works

Sweat glands secrete in response to nerve signalling. Botulinum toxin temporarily interrupts that signal in the treated area, reducing sweating there.

Two points follow, and both matter for expectations. The effect is local — treating the underarms does not affect sweating elsewhere, and the body does not compensate by sweating dramatically elsewhere in the way patients often fear. And it is temporary: nerve signalling recovers, so this is a repeated treatment, not a cure.

By Site

Underarms

The most commonly requested site, usually because of visible marks on clothing and persistent dampness. Comparatively tolerable to treat.

If odour rather than wetness is the main concern, that is a related but distinct issue and is assessed separately — reducing sweat helps, but it is not primarily an odour treatment.

Palms

For hands wet enough to interfere with paper, devices or shaking hands. The palm is densely innervated and injection here is noticeably more uncomfortable than the underarm; measures to reduce discomfort are discussed beforehand rather than improvised.

Soles

For damp feet and associated odour. As with palms, sensitivity is high and comfort measures are planned in advance.

Onset and Duration

Reduction generally begins within several days and reaches full effect at about one to two weeks. Duration is commonly in the region of 4–6 months for underarms, often shorter for palms and soles where the treated area is used constantly.

Many patients time treatment ahead of summer or a specific event for this reason. Individual variation is considerable.

Risks & Considerations

• Pain during injection — substantially more in palms and soles than underarms
• Bruising, swelling or tenderness at injection sites
• Temporary weakness of grip after palm treatment, from diffusion into nearby small hand muscles — usually mild and resolving, but relevant if your work requires fine hand strength
• Mild compensatory sweating elsewhere in some patients
• Incomplete response — reduction rather than elimination
• Rarely, allergic reaction or headache

Not appropriate during pregnancy or breastfeeding, or with certain neuromuscular conditions. Secondary hyperhidrosis with an underlying medical cause should be investigated rather than only treated symptomatically.

Frequently Asked Questions

Q. How long does it last?

Commonly around 4–6 months for the underarms, often shorter for palms and soles. Individual variation is significant.

Q. Does it hurt?

Underarm treatment is generally tolerable. Palms and soles are considerably more sensitive, and comfort measures are arranged in advance for those sites.

Q. Will I sweat more somewhere else?

Mild compensatory sweating is reported by some patients but is usually not troublesome. The dramatic compensation people worry about is associated with surgical nerve division, not with injection.

Q. Will it stop body odour?

Reducing sweat usually reduces odour, but odour has its own contributing factors and is assessed separately. It is not accurate to describe this as an odour treatment.

Q. Is it permanent?

No. Nerve signalling recovers, so treatment is repeated. Anyone describing a permanent result from injection is not describing this treatment.

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