Botox for hyperhidrosis temporarily reduces excessive sweating by interrupting the nerve signals that activate sweat glands in the treated area. It is FDA-approved for severe primary underarm sweating that has not improved enough with topical treatments. InjectCo charges $12 per unit, and the total cost depends on the treatment area and recommended units.
Written by Jen Adams, BSN, RN. Medically reviewed by Dr. Josh Allen, D.O., Medical Director, InjectCo MedSpa. Last updated August 2026.
Medical disclaimer: this article is patient education and does not replace medical advice. Botox is a prescription medication and a licensed provider must decide if treatment is appropriate. Individual results vary.
Botox reduces sweating by blocking the release of acetylcholine, the chemical messenger that tells sweat glands to activate. The effect remains limited to the areas where the medication is injected and gradually wears off as nerve signaling returns.
This process differs from cosmetic Botox. Cosmetic injections target muscle movement, while hyperhidrosis treatment places small amounts of Botox just beneath the skin near the sweat glands.
The medication does not remove the glands or permanently stop them from working. Repeat treatment may be needed once sweating returns.
Treating a limited area, such as the underarms, does not stop the rest of the body from sweating. The International Hyperhidrosis Society reports that the underarms contain less than 2% of the body’s sweat glands, so localized treatment has little effect on overall temperature regulation.
The goal is to reduce sweating that exceeds what the body needs, not to eliminate normal perspiration throughout the body.
Botox has FDA approval for severe primary axillary hyperhidrosis, which means excessive underarm sweating that has not improved enough with topical agents. Treatment of the hands, feet, face, and other areas is off-label because the FDA has not established its safety and effectiveness for those locations.
Underarm Botox has the strongest regulatory and clinical support. The FDA-recommended dose is 50 units per underarm, placed in several shallow injection sites across the sweating area.
Treatment may help patients dealing with:
The provider may use an iodine-starch test to map the areas producing the most sweat before placing the injections.
Botox may be used off-label for palmar hyperhidrosis. It can reduce sweating in the palms, but the injections may be more uncomfortable than underarm treatment.
Temporary hand weakness can occur if the medication affects nearby muscles. This possibility matters for patients whose work, sports, or daily activities depend on grip strength and fine hand movement.
Treatment may also be considered for plantar hyperhidrosis. Foot injections are off-label, can be uncomfortable, and may provide less consistent results than underarm treatment.
The International Hyperhidrosis Society notes that foot injections tend to be more painful and may produce lower patient satisfaction.
Small amounts of Botox may be used off-label for excessive sweating of the forehead, face, or scalp. Placement requires careful planning because the medication can affect the muscles that control brow position and facial expression.
Possible complications include temporary asymmetry, brow changes, or eyelid drooping. Patients considering hyperhidrosis face Botox should choose a provider experienced with facial anatomy and medical Botox treatment.
Meet with an InjectCo nurse to review where you sweat, how often it happens, and which treatment areas may be appropriate.
InjectCo lists Botox for hyperhidrosis at $12 per unit. Your total depends on the area being treated and the number of units recommended during consultation.
The FDA-recommended underarm dose is 50 units per side, or 100 units for both underarms. At InjectCo’s current rate, that provides the following estimate:
| Treatment Plan | Estimated Units | Estimated Cost |
| One underarm | 50 units | $600 |
| Both underarms | 100 units | $1,200 |
| Hands, feet, or face | Varies | Confirmed after assessment |
The underarm estimate uses the FDA-labeled dose. Your provider may adjust the treatment plan after evaluating the sweating pattern, treatment history, and area size.
Hands, feet, and facial treatment do not have one standard cosmetic price. Those areas require custom unit planning because they differ in size, sensitivity, injection technique, and risk.
Prices may change. See current Botox pricing, then confirm the rate, recommended units and complete cost at your consultation.
Review your treatment area and estimated units before receiving a final price from an InjectCo provider.
Insurance may cover Botox for medically diagnosed hyperhidrosis, but approval is not guaranteed. Coverage depends on the insurance plan, treatment area, diagnosis, previous treatments, and medical-necessity requirements.
Some insurers may ask for:
Coverage may be more likely for severe primary underarm hyperhidrosis because that use is FDA-approved. Treatment of the hands, feet, or face is off-label and may be harder to get covered.
Patients with eligible commercial insurance may also qualify for the manufacturer’s BOTOX savings program. Eligibility rules, reimbursement limits, and exclusions apply, and the program is separate from health insurance.
Ask both your insurer and the treating clinic about billing before scheduling. A consultation or quote does not guarantee reimbursement.
Underarm sweating may begin decreasing within two to four days, with fuller effects commonly developing within two weeks. Results often last four to 12 months, though some patients experience a shorter or longer response.
Duration can depend on:
The effect fades gradually. Patients commonly notice moisture returning in smaller areas before the full sweating pattern comes back.
Hand treatment often lasts around six months, while foot treatment may wear off within three to four months for some patients. These areas are off-label, so timing is less predictable than labeled underarm treatment.
Repeat injections should be considered after the previous effect decreases rather than according to a fixed calendar date. For cosmetic treatment areas, see how long Botox lasts.
Hyperhidrosis Botox uses several shallow injections spread across the sweating area. Underarm treatment commonly involves 10 to 15 injection points per side, placed approximately one to two centimeters apart.
Most patients describe underarm injections as short pinches. The hands and feet contain more sensitive nerve endings, so treatment there may feel more uncomfortable.
Comfort options may include:
Tenderness, small bumps, mild redness, or bruising can occur at the injection sites. These effects usually settle without a lengthy recovery period.
Ask an InjectCo nurse about injection mapping, comfort options, aftercare, and the expected result timeline.
Botox may fit adults with focal sweating that continues despite appropriate topical treatment. The strongest candidates have symptoms concentrated in specific areas rather than unexplained sweating throughout the body.
Clinical-strength or prescription antiperspirants are often an early treatment for focal hyperhidrosis. Hands and feet may also respond to iontophoresis, while other prescription products may be discussed for selected patients.
Botox may not be the first step when a less invasive treatment has not yet been tried.
Tell your provider if you:
New or widespread sweating can be linked to medication effects, hormonal changes, infection, thyroid problems, or other medical conditions. Those concerns need evaluation before a provider focuses only on sweat reduction.
Seek urgent medical care after Botox for trouble swallowing, speaking, or breathing, widespread weakness, double vision, or other symptoms of toxin spread. BOTOX carries a boxed warning for the possible distant spread of toxin effects.
Your hyperhidrosis Botox treatment at InjectCo starts with a medical consultation. The provider needs to understand your sweating pattern before recommending Botox.
Your nurse asks where you sweat, when it began, how often it happens, and how it affects daily activities. You should also explain which antiperspirants, medications, or treatments you have already tried.
Sweating that begins suddenly, occurs throughout the body, or happens mainly at night may require further medical evaluation. The Botox prescribing information advises providers to consider possible secondary causes, such as thyroid disease, before treating the symptom alone.
Your provider reviews medical conditions, medications, allergies, previous botulinum toxin treatments, pregnancy, breastfeeding, and any past reactions.
Botox should not be injected through infected skin or given to patients with a known hypersensitivity to a botulinum toxin product or its ingredients.
The provider identifies the areas producing excessive sweat. An iodine-starch test may be used for underarm treatment to show the active sweating zone.
This helps the nurse distribute the injections across the correct surface area rather than treating only the center of the underarm.
Your nurse explains the treatment area, recommended units, current unit rate, estimated total, expected duration, and possible side effects.
You can ask questions or decide not to proceed before any medication is placed.
The skin is cleaned, and Botox is placed just beneath the surface in a grid pattern. Appointment length depends on the treatment area and comfort methods used.
Most patients return to routine activities after the appointment, and our Botox aftercare guide covers the first 24 hours. The International Hyperhidrosis Society recommends avoiding intensive exercise and sauna use for the rest of the treatment day.
Your nurse will explain when to assess the result and when follow-up may help identify areas that still sweat.
Meet with a nurse injector to review your symptoms, treatment area, recommended units, pricing, recovery, and insurance questions.
Common questions about Botox for excessive sweating, including cost, insurance, duration and which areas are FDA-approved.
Botox temporarily blocks acetylcholine, the chemical signal that activates sweat glands. Sweating decreases in the skin where the injections are placed.
InjectCo lists Botox at $12 per unit. The FDA-recommended underarm treatment uses 50 units per side, so a typical 100-unit bilateral plan costs about $1,200. Your final cost is confirmed after assessment.
Some plans cover medically necessary underarm treatment after documentation, previous topical treatment, and prior authorization. Coverage varies, and off-label treatment areas may be less likely to qualify.
Underarm results commonly last four to 12 months. Hand, foot, and facial treatment may follow different timelines. Individual response varies. (International Hyperhidrosis Society)
The FDA-recommended dose is 50 units in each underarm, or 100 units total for bilateral treatment. The medication is distributed through several shallow injection sites. (FDA Access Data)
Underarm injections usually feel like quick pinches. Hand and foot injections can be more uncomfortable, so additional numbing or anesthetic methods may be discussed.
No. FDA approval covers severe primary underarm hyperhidrosis that has not responded adequately to topical treatment. Treatment of other areas is off-label.
Compensatory sweating is commonly associated with certain hyperhidrosis surgeries. The International Hyperhidrosis Society reports that it has not been identified as a major concern with localized Botox treatment.
No. Botox temporarily reduces sweating in the treated area. Repeat treatment may be needed when nerve signaling and sweating return.
Botox can provide several months of sweat reduction when focal hyperhidrosis continues despite topical treatment. Underarm treatment has FDA approval and a standard labeled dose, while treatment of the hands, feet, and face requires a more cautious off-label discussion.
Your InjectCo consultation will review the sweating pattern, possible medical causes, previous treatments, recommended units, expected cost, insurance questions, and possible side effects before you decide.
Meet with a licensed nurse injector to review your symptoms, treatment area, units, pricing, result timeline, and insurance questions.
Dr. Allen earned his Doctor of Osteopathic Medicine at Lake Erie College of Osteopathic Medicine and completed his emergency medicine residency with Texas A&M. As Medical Director, he reviews InjectCo’s treatments, protocols, and patient education content for accuracy and safety across all nine Texas locations.
