Excess Sweating: Hyperhidrosis

At Loftus Street Dermatology, Dr Gary Moloney has a special interest in the novel treatment of excess underarm sweating with Botox injections. Ask your GP if referral is appropriate.

Excess sweating (hyperhidrosis) on the palms/ soles cannot be treated with Botox. We generally recommend purchasing an electronic device (an Iontophoresis Machine) for these problems.

What is Botox®?

Botulinum Toxin, commonly known as Botox®, is a protein toxin obtained from special bacteria Colostridium Botulinum. Botox is an effective treatment for excessive sweating of the armpits in those people who have not responded to antiperspirants.

Botox® when injected under the skin of the affected area paralyses the small nerves supplying the sweat gland and as a result reduces the amount of sweat produced. The effect of Botox® treatment on the sweat glands starts within 2 weeks, and usually lasts between 4-12 months after which time further treatment will be needed.

How is it administered?

A small volume of the Botox® solution is injected in the affected area of the skin through 20 small jabs using a fine needle. You may experience mild pain/discomfort. Using an ice pack during the procedure will help reduce the discomfort. Most people find it tolerable.

Any special preparations required?

No special preparation required except we advise you, if possible, to shave clean your armpits on the morning of the procedure and avoid putting on any deodorants (roll-on or spray).

What will happen when I attend for my treatment?

In total you will be in the rooms for about 30 minutes. On arrival please report to the reception at the dermatology unit and a nurse will attend to you. The dermatologist will explain the procedure to you and you will have the chance to ask any questions.

You will need to sign:

1. A consent form to confirm that you are happy to go ahead with the treatment.

2. An Epic Pharmacy co-payment form (PBS)

3. A PBS Authority prescription

A nurse will take you to the treatment room and make sure that the area under your armpit is clean. A cold pack will be applied over your armpit to numb the skin; you can ask not to have it if you prefer so. Each armpit will be injected with a fine needle 20 times, in order to spread the Botox over the whole of the affected area.

After completion of the treatment you will be observed for 10 to 15 minutes to ensure that you did not develop any reaction or allergy to the Botox treatment.

Before you leave you will be provided with a review date for the assessment of the treatment effect.

Is it a permanent cure for my armpits sweating?

No, the treatment keeps the armpits relatively dry for between 2-12 months before the excessive sweating returns. On average many people have relief for between 4-6 months; thereafter the injection will have to be repeated.

Are there any side effects to this treatment?

No major side effects have been reported so far except for mild pain and bruising at the site of the injections. Uncommonly, swelling, itch or rash, infections of the skin occur. Very few people have complained of excessive sweating elsewhere in the body for a short period of time following the injection. Transient weakness of the arms and arm pain has also been reported, as has neck pain, fever or a sore throat, but these are very rare. Allergic reaction to Botulinum Toxin is possible, but not commonly observed in practice. An inadequate reduction in sweating is occasionally observed.

The treatment is not recommended for pregnant or breast feeding women, children under 12, those on certain medications (injected aminoglycoside antibiotics), those allergic to Botox® and those with neuromuscular disorders (Eaton-Lambert, motor neurone disease, myasthenia gravis, etc).

Are there any precautions required after the treatment?

I generally advise that you avoid strenuous exercise or taking a hot bath for the 24 hours following treatment. Do not massage the area for a least 4 hours. You can return to antiperspirant use on the following day if desired.

How much does it cost?

Most of the cost of the Botox® is covered by the PBS if certain criteria are met. There is a small out-of-pocket patient co-payment required. There is also a Medicare rebate available for the dermatologist’s procedure fee, and this will outlined for you before the treatment.

Iontophoresis Machines

These can be used to treat excess sweating of palms and soles and can also be used to treat armpit sweating with the purchase of foam wedges.

A good summary of some available machines : http://hyperhidrosisnetwork.com/top-iontophoresis-machines/

Use machine daily for 2-3 weeks on maximum settings. If no improvement, book in to see us to discuss script for 'glyco-pyronium' to put in tap water to improve effect.

Once the sweating is under control, use the machine 3/wk, 2/wk, 1/wk etc.

Buyer beware! - ensure 240V compatible with Australian electrical supply.

-Check warranty/ return policy before purchasing.

-Check GST/Import Duty/Shipping costs.

-Check with your private insurance regarding rebate.

-Try to find an Australian distributor rather than purchasing overseas/ online.

-The more expensive 240V machines are more effective than battery powered ones.


443 Albany Highway, Victoria Park, Perth, WA 6100

PO Box 159, Victoria Park, Western Australia 6979

Tel: (08) 9470 5677 Fax (08) 9470 5589


hand & foot: approx $500