Dr. Saber’s Blog

Don’t Sweat It: Botox for Hyperhidrosis is Here

Can Botox Help You Sweat Less?

We humans sweat for two reasons. Firstly, as a cooling mechanism – the presence of sweat on a person’s skin cools them through evaporation. This sort of cooling sweat is produced by our eccrine glands, which are located over the entire body and concentrated in areas like the armpits, palms of the hands, forehead, and soles of the feet.

The second type of sweat production is a response to emotional pressure. Stress sweat is produced by our apocrine glands, which are larger than the eccrine glands. The apocrine glands are mostly located in the armpits, groin, and upper chest. These glands produce sweat in response to a stressful challenge, such as the sweat accompanying stage fright, a.k.a. “flop sweat.”

What is hyperhidrosis?

About 2% of Americans suffer from a condition known as hyperhidrosis. These folks sweat excessively, and they do so irrespective of the usual sweat triggers. They sweat when it’s cool, and they sweat when they’re calm. They sweat whether they’re happy or sad, and when they’re under no stress at all. And they sweat a lot. They sweat nearly continuously. They produce at least four times as much sweat as an ordinary person. 

Man with sweaty forehead

As you can readily imagine, hyperhidrosis inflicts a hugely negative impact on a person’s quality of life. For example:

  • How do you shake someone’s hand when you know you will leave the other person’s hand dripping with your sweat?
  • How do you kiss your date when your forehead is sopping?
  • How do you type a memo when your slippery wet fingers keep sliding off the keys?

To its victims, hyperhidrosis can feel like a plague comparable to the bugs, frogs, and pestilence that Moses inflicted upon the Egyptians.

Hyperhidrosis isn’t physically harmful but can be physiologically devastating

Until 2004, hyperhidrosis continued to be one of the most frustrating conditions known to dermatologists. When compared to other dermatology conditions, hyperhidrosis does very little physical harm as it merely makes its victims “very leaky.” As long they stay hydrated, they remain systemically healthy,

However, from a practical and emotional viewpoint, severe hyperhidrosis is devastating. Metaphorical rivers of sweat form daunting barriers to both relationships and careers.

What causes excessive sweating?

There are two kinds of excessive sweating, “primary hyperhidrosis” and “secondary hyperhidrosis.”

Primary hyperhidrosis is idiopathic, which is medical jargon for “nobody knows its cause.” But we know that something generates overactivity of the hypothalamic regulatory center in the brain and that the sympathetic nervous system transmits overactivity to the sweat glands, where it results in copious sweating.

What we know about primary hyperhidrosis:

  • It generally starts in childhood or early adolescence
  • Primary hyperhidrosis may persist throughout a person’s life or diminish with age
  • There’s often a family history
  • Sweating tends to decrease at night, and almost always disappears when a patient is asleep

Secondary hyperhidrosis, as the name “secondary implies,” is caused by some other underlying medical condition. Some of the conditions that cause secondary hyperhidrosis are:

  • Substance abuse
  • Obesity
  • Diabetes
  • Menopause
  • An overactive thyroid
  • Chronic anxiety disorder
  • Respiratory failure
  • Endocrine tumors
  • Parkinson’s disease
  • A brain tumor

Focal hyperhidrosis is localized, i.e., concentrated in specific areas of the body (armpits, palms, soles, face). Hyperhidrosis can also be generalized – affecting most or all of the body.

Primary and secondary hyperhidrosis are often accompanied by irritant dermatitis and skin infections. The hands of those with palmar hyperhidrosis are prone to a blistering type of dermatitis. Additionally, the feet of those with plantar hyperhidrosis are prone to podiatric infections. 

What is the treatment for hyperhidrosis?

Botox injections for feet sweating

There are several treatment methods to mitigate hyperhidrosis. They begin with the simpler modes, such as extra-strength antiperspirant, usually containing aluminum chloride. Some oral medications block acetylcholine, the chemical that triggers the sympathetic nervous system to over-stimulate the sweat glands. 

These treatments are generally of limited effectiveness and often accompanied by significant side effects. Side effects can include itching, irritation, dry mouth, blurred vision, constipation, and/or stomach cramps.

For the most severe cases of hyperhidrosis, a doctor may use microwaves to destroy sweat glands or surgically remove them. 

Hyperhidrosis surgery

Endoscopic thoracic sympathectomy (ETS) is one type of hyperhidrosis surgery; it’s only used in the most severe cases involving the palms or armpits. Small incisions are made in the affected area, and the nerves that control sweating are cut. ETS is an effective treatment because the severed nerves can no longer transmit the signals that cause excessive sweating. 

There are of course potential negative side effects from ETS. One such unwanted result is excessive compensatory sweating in other areas, such as the face and neck. This side effect usually occurs after eating and is called gustatory sweating. Other complications of ETS can include damage to the nervous system that results in a permanently drooping eyelid. 

Botox injections for hyperhidrosis to the rescue!

In 2004, the FDA approved the neurotoxin Botulinum Toxin Type A (named Botox by Allergan, its manufacturer) for the treatment of underarm hyperhidrosis. Clinical studies show that Botox decreases underarm sweating 82 – 87%.

The injection of botulinum toxin is also used for other hyperhidrosis locations, including the hands and feet.

Botox (and its close European relative, Dysport) is easy to use and has quickly become the medical equivalent of duct tape – it works for almost everything.

Today Botox is used for a myriad of conditions, including:

And, of course, Botox continues to fulfill its most prominent role as an aesthetic eraser of facial wrinkles and frown lines.

How is Botox for hyperhidrosis administered?

Botox treatments can be accomplished in a physician’s office and the drug administration takes relatively little time. Trained and experienced healthcare providers can inject both underarms in under 15 minutes. There are no consequent restrictions of work or leisure activities, aside from avoiding intensive exercise or using a sauna on the day of the injections. Underarms and the forehead are the easiest areas to treat and get the best results.

Woman receiving botox for hyperhidrosis

During the procedure, a very fine needle is used to inject tiny amounts of Botox just under the skin in a grid pattern covering the area of excessive sweating, with about 25 individual injection sites spaced around 1 – 2 cm apart. Follow-up appointments are recommended about two weeks after the initial procedure.

The beneficial effects of Botox will usually last from 6 to 14 months, and the treatments can be repeated with no harmful accumulative effects. The cost varies geographically, but treatment for both underarms usually costs around $1,000. There is no doubt that hyperhidrosis treatment is medically necessary, so most insurance plans should cover the injections.

Potential side effects of Botox for hyperhidrosis

Side effects of Botox treatment for hyperhidrosis are usually brief and mild. There is some pain, but a local anesthetic can reduce that side effect. There can be some residual muscle weakness around the injection area, but that is also temporary.

Why Choose Saber Plastic Surgery for Botox treatment for hyperhidrosis?

Dr. Saber is a highly respected board-certified plastic and reconstruction surgeon who offers a more sensitive, female perspective for patients of all ages, genders, and orientations. Patients from all walks of life have praised not only their treatment outcomes but her caring, thoughtful approach to a wide array of appearance and health-related matters.

A graduate of Stanford University’s world-renowned medical school, she did her plastic surgery residency at the University of Southern California (USC). She then completed a fellowship at New York University (NYU) in the extremely challenging and delicate hand surgery and microsurgery disciplines.

To request a consultation, call 877-205-4100 or schedule a consultation online.

Dr. Saber takes her patients’ safety very seriously. Her facility’s Covid-19 patient safety procedures exceed all CDC and World Health Organization recommendations. Masks are required in our office during the coronavirus pandemic.

The practice of Dr. Saber is located in Encino, CA, for patients throughout the Los Angeles area. We are also convenient to Woodland Hills, Sherman Oaks, Calabasas, Burbank, Glendale, Hidden Hills, Agoura Hills, Northridge, North Hollywood, Malibu, Topanga, Canoga Park, Reseda, Valley Glen, Chatsworth, West Hills, Winnetka, Universal City, Bel Air, Beverly Hills, Downtown Los Angeles, Silverlake, and Echo Park.

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    Dr. Sepideh Saber, MD, FACS

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  • What patients say about Dr. Saber

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    I was fortunate to find Dr. Saber after researching board-certified surgeons who specialize in breast cancer reconstruction revision surgery. I knew I was in good hands from the moment I spoke with the lovely and efficient Marlene, Dr Saber's office manager. Dr Saber patiently listened to my concerns and, after examining me, explained what I could realistically expect the outcome to be from another surgery. She also explained to me that she would need to review my previous surgery notes before we could discuss a possible further surgery, which I found comforting and highly ethical. I also discussed a couple of other procedures that I would like done, including fat removal from my large upper arms that had caused me great embarrassment for several years. Dr. Saber is an excellent surgeon who is incredibly kind and genuine. She truly understands the female body and the emotional aspect of body insecurities yet, she is transparent about what can and cannot be done and takes time to discuss realistic expectations and outcomes. My breast reconstruction revision surgery will take place in the New Year, but in the meantime, I have the most fabulous upper arms that I recently flaunted in a strapless dress (something I have not done in years). Dr Saber is truly one of a kind, and I still cannot believe how fortunate I am to have found her. I highly recommend Dr Saber.

    Linda DeCarlo November 29, 2023

    I don’t have enough wonderful words to describe Dr Saber and Marlene! I had a tummy tuck done this year and from start to finish the entire experience was amazing. Marlene is always so helpful and works so hard to make every detail a breeze for you. When I had my consultation with Dr Saber I was at a point of complete agony with my body. She instantly took that stress and frustration off my shoulders! As a woman not being heard by doctors for years I left that consultation with happy tears knowing I had finally found my Dr. It was a major surgery and I felt completely zen and at peace going in because she really does make you feel that safe. I didn’t think I would ever look the way I do now! She gave me the gift of having the body I kept fighting for. I will never stop recommending her.

    Monica Prusa October 9, 2023

    I saw Dr. Saber when I broke my wrist. I ended up having to have surgery. She did an excellent job and I am healing nicely. She was very professional, but was also very kind and compassionate. I would highly recommend her!!

    Sandy Schaupp September 13, 2022

    I LOVED DR SABER!!! There are a few reasons why I chose her. One was because she’s a female Doctor that was my goal who also did a good job (which I was able to confirm with all her before and after photos) and what sold me was my safety in mind. She made me feel like I was in the best hands ever along with Marlene who coordinated everything THANK YOU LADIES! Dr Saber helped me get back the body I have always desired. I had a lot of stomach fat from weight gain and I lost weight so a lot of my weight was in my front lower and upper abdomen. Now I have a super beautiful curvy body like an hourglass after a tummy tuck and lipo she did. She understood the assignment hahaha . I’m 32 years old no kids just wanted to enjoy my younger body looking and feeling beautiful and she really took good care of me. Even after hours I had an emergency due to my fault but she was there and got back to me very quickly and I’m very grateful. I also think her work says a lot because I stopped taking pain medication on the 3rd day after surgery and was fine with very minimal pain I was able to tolerate the healing process. Highly recommend going with her I just had a wonderful experience and would do it all over again if I had too. Maybe after I have kids. Thanks Dr Saber and team <3

    STEPHANIE d July 15, 2022

    Dr.Saber is by far one of the best plastic surgeons. I love how she takes her time to explain any procedure to the patients understanding. She always makes sure to answers any and all questions.From fillers to body contours she’s the one you want.

    Katherine Melara February 15, 2022

    Dr Saber is amazing! She is caring and very informative. I went in for fillers and she explained procedure step by step. I highly recommend her and look forward to future visits.

    Amanda Vazquez December 18, 2020

    Dr. Saber was friendly, knowledgeable and professional. She took time to listen, answer all my questions and was forthright in her recommendations. Her staff was friendly and helpful. I was very happy with the results and plan on going back. If you are looking for a first rate professional experience look no further she is the doctor for you!

    T R December 18, 2020

    Dr. Saber is one of a kind plastic surgeon with a heart of gold. She is a well verse plastic surgeon that puts her patient's needs before anything else. She genuinely cares about every single patient, and her work speaks for itself. I notice every post-operative result on her Instagram (@saberplasticsurgery) the patients have this glow that radiates through. I have been going to Dr. Saber for my Botox for the past 3 years, and love the results every time. I know who I will be going to for any future plastic surgery needs, and will confidently refer family and friends to Dr. Saber for any Botox, fillers, and plastic surgery consultations.

    Rudy Garcia December 16, 2020

    I have nothing but great things to say about Dr. Saber! I am so pleased with my results from a breast augmentation she performed on me back in late June! She answered all my questions and concerns before and after my surgery. She’s very easy to get in contact with and she’s so nice. She made feel so comfortable throughout the whole process. 100/10 Lover her work!!

    Amanda Villegas October 15, 2020

    Dr Saber is hands down the best surgeon! She took her time answering my questions and explained procedure in detail. After doing liposuction six months ago, I am extremely happy with my results and I appreciate her so much.

    Marlene Cosentino October 15, 2020

    Dr. Saber is so kind and thorough with her patients! She is an amazing doctor and genuinely cars about everyone she comes in contact with. I would recommend her to anyone for any hand surgery or cosmetic procedure.

    Rachel Meach October 15, 2020