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Don't Sweat It. Botox Injections Help Keep Heavy Perspirers Dry

Feb. 14, 2001 -- Hanne Heilesen had suffered from excessive underarm sweating for more than half her life and had reluctantly decided to undergo surgery for the problem when her doctor told her about a treatment involving injections with a toxin associated with a deadly form of food poisoning.

"I was skeptical at first, but I really didn't want to have surgery, because I had read about complications," the 38-year-old woman from Brussels, Belgium, tells WebMD. "But I had to do something. I was beginning a new career in personal growth training, and I didn't want to be in front of people all day worrying about the sweat under my arms."

In mid-December, Heilesen had her first injections of botulinum toxin A, known as Botox in the U.S., now widely used by dermatologists to smooth facial wrinkles. She received 12 injections under each arm to temporarily paralyze her overactive sweat glands and now says that the treatment was an unqualified success.

"It has made all the difference. I used to have to change T-shirts two or three times a day and was always having to think about this," she says. "Even at my wedding, I had to have special pads made to match my dress to avoid having sweat marks. Now I can wear any kind of clothes without having to worry."

Although more and more dermatologists are using Botox for the treatment of excessive sweating, until now there have been no large studies proving its effectiveness. In the Feb. 15 issue of The NewEngland Journal of Medicine, researchers from Munich, Germany's Ludwig-Maximilians University report that the toxin was both safe and effective in the treatment of 145 patients with underarm hyperhidrosis. The vast majority of patients still had substantial reductions in underarm sweat six months after receiving treatment, and almost all (98%) said they would recommend the therapy to others.

About 1% of Americans have the condition known as hyperhidrosis, or excessive sweating. It can occur in the hands, armpits, feet, face, trunk, or a combination of locations, and usually begins during childhood or adolescence. While the cause remains something of a mystery, there appears to be a strong genetic component to excessive sweating, with about 70% of those seeking treatment reportedly having a close relative with the disorder.

Current treatments range from the simple -- the use of antiperspirants with aluminum chloride -- to the extreme -- the removal of underarm sweat glands. A relatively new and less invasive surgical technique known as endoscopic thoracic sympathectomy (ETS) is also gaining popularity but is still somewhat controversial. Though supporters of the procedure claim that its side effects are minimal, others say it can result in nerve damage and may have unacceptable side effects.