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Click here to view Frequently Asked Questions
about BOTOX® Cosmetic for Palmar Sweating
What causes excessive palmar sweating?
Hyperhidrosis is the medical term for excessive sweating, and when
it occurs on the palms it is called "palmar hyperhidrosis." This is
caused by stimulation of the eccrine sweat glands (pronounced ek'-krine)
by the nerve endings which are the final nerve pathways from higher
centers in the brain. These nerves respond to different kinds of stress
- emotional stress like intimate social situations or public
speaking, or physical stress like the increased body temperature that
comes with exercise or hot and humid weather. Some people are plagued
with excessive sweating on a round-the-clock basis. Other people are
bothered only when they are under emotional stress, physically active,
or over-heated. In either case, BOTOX® Cosmetic Purified Neurotoxin Complex*
may be the answer. The nerves that control sweating depend upon a
chemical transmitter called acetylcholine which is a molecule produced
at the very ends of the nerve fibers. BOTOX® Cosmetic is a genetically engineered
neurotoxin which can, when injected into the skin, block the release
of the acetylcholine to the sweat glands for months!
What are the alternative treatments?
Topical Antiperspirants
Topical antiperspirant sticks, creams, lotions, and solutions typically
use aluminum chloride solutions. They are highly irritating with continued
use, and largely ineffective for people with excessive sweating.
Anti-cholinergic drugs & tranquilizers
Medications currently used cause dry mouth, blurred vision and minimally
reduce sweating. Tranquilizers may minimize your anxiety over sweating
but rarely diminish the flood.
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Tap Water Iontophoresis
Various battery powered electrical devices have been used over the
years which use a tap water moistened pad and electrical current
held against the palms for several hours. This decreases the sweating
but is very time consuming, needs to be repeated on a daily or weekly
basis, and is only mildly effective for severe cases.
Surgery
Thoracic surgeons and neurosurgeons use a fiber-optic surgical tube
inserted into the neck or through the underarm skin to cut the nerve
fibers next to the spine which lead to underarm sweat glands and
palms (endoscopic sympathectomy or ETS). This approach involves
the risk of localized paralysis, loss of sensation, and even drooping
eyelid or permanent dilation of the pupil of the eye as reflex injury.
Cases of compensatory hyperhidrosis where there is an unwanted increase
in sweating elsewhere have been reported. ETS should be attempted
only with very experienced surgeons.
How is BOTOX® Cosmetic given?
A very small needle is used to inject small drops of BOTOX® Cosmetic into the
palmar skin of the hand in approximately 30 places. The procedure
takes only a few minutes in the office and required no anesthesia.
Heavy physical exercise should be avoided for several hours, but patients
may engage in any normal activity. We prefer to treat one hand first
and the other hand in one week.
When will BOTOX® Cosmetic take effect?
Your palmar sweating will decrease within 48 hours and the full effect
will be seen in about 1 to 2 weeks.
How long does BOTOX® Cosmetic last?
Most patients will obtain 6 to 10 months of dryness after treatment
with BOTOX® Cosmetic.
What are the risks and complications?
The only complications from injection into the palmar skin are:
- Tiny bruises are occasionally seen which fade in a few days
- Occasionally small persistent areas of sweating may need a second
treatment session
- Some temporary weakness in grip strength which may last up to two
weeks. There is no risk of numbness, or permanent weakness.
Who are good candidates for "No Sweat"
BOTOX® Cosmetic?
 People with unwanted palmer sweating...
- People working close to others who need to touch: hairstylists,
nurses ,dentists and hygienists, MD's.
- People working in retail who handle sensitive material: salespeople
in clothing, jewelry, stationary, accessories.
- People working in hot conditions: models, television newscasters,
chefs and photographers
- People handling lots of paper: executives, attorneys, salesmen,
stockbrokers and title company workers
- People who need to use keyboards extensively: typists, computer
programmers and software engineers.
 People who handle money: cashiers, tellers and reception desk personnel.
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