How to Stop Sweating Once-and-For-All

botox to stop sweating
Botox injections can reduce your sweating by at least 80 percent. Peter Dazeley / Getty Images

There are a lot of great things about summer. Sweating isn’t one of them. For most men, the increase in sweat is a warm-weather nuisance you put up with because hey, it’s summer, and it’s nothing extra antiperspirant, a cold shower, and changing your T-shirt can’t solve. But for others, summer only exacerbates what is already a year-round pain in the ass as millions experience levels of sweating so intense that OTC and even Rx antiperspirants can't stop the flood. Heavy sweaters, we’re here to help.

The good news is that excessive sweating doesn’t have to put a stain on your summer plans. “If topical treatments fail, and medical-grade antiperspirants don’t work, the next step is Botox,” says Anthony Rossi, M.D., a dermatologist at Memorial Sloan Kettering Cancer Center in New York City. There are a few other clinical options besides the stuff that removes forehead wrinkles, but most have side effects, he says. Here’s how Botox can stop you from turning into a sweaty mess.

What Is Botox?
You know it as Botox, but that’s the brand name. The generic name for the compound is botulinum toxin, and it's a naturally occurring protein that blocks the chemical in your body responsible for “turning on” the body’s sweat mechanism. Despite gaining approval as a sweat antidote by the FDA more than 10 years ago, Botox has only recently caught on in popularity.

How Exactly Does Botox Stop Sweat?
“Botox prevents your nerves from sending the message to your sweat glands to rev up production,” says Josh Zeichner, M.D., an assistant professor of dermatology at Mt. Sinai Medical Center in New York. By blocking the secretion of the chemical that initiates the sweating process, “this translates to less wetness wherever Botox is used — typically the underarms, hands, and feet,” says Dr. Zeichner.

Is Botox Effective?
Botox won’t cure you of embarrassing sweat stains for the rest of your life — a treatment lasts three to eight months — but it can control the intensity of your sweating and significantly reduce your sweat rate. Research finds that there is usually an 82 to 87 percent decrease in sweat production at the underarms after being treated with Botox, and up to a 90 percent reduction in sweaty palms, according to the International Hyperhidrosis Society. There are no restrictions on where Botox can be used, so the injection area comes down to what a patient wants, says Dr. Rossi. If someone wants to eliminate their constantly clammy palms, they'll target their hands, he says.

Do the Injections Hurt?
The procedure is straightforward (you can get it done on your lunch hour), but it does involve dozens of microinjections that aren't exactly pleasant. “Injections in the hands can be painful, so numbing creams or even nerve blocks may be given,” says Dr. Zeichner. “Topical numbing creams or ice are commonly used under the arms.”

The actual procedure takes only 20 to 30 minutes. “First, we do a starch iodine test to see where a patient is sweating most,” explains Dr. Rossi. “Then, we do a series of microinjections, which vary in number depending on location. If we are treating your hands, it’s about 25 injections.”

Is Botox Risky?
“Botox is used cosmetically to reduce the appearance of wrinkles by relaxing the underlying muscles in your face,” says Dr. Zeichner. “One of the side effects as a treatment for sweat is the potential to develop muscle weakness. This could mean temporary weakness and loss of dexterity in the hands for several weeks.”

To reduce the possibility of this happening, dermatologists avoid injecting Botox too deeply under the skin. “We also use different concentrations of Botox than in cosmetic procedures, so it shouldn’t interfere with the underlying muscles the way it does for wrinkle treatments,” says Dr. Rossi.

Will It Cost a Lot?
What you’ll pay depends on your situation and your insurance plan. “If you want insurance to cover the procedure, you need a clinical diagnosis,” says Dr. Rossi. Even then, not all plans cover it. Without insurance, you can expect to pay around $1,500 per session — and you’ll need to schedule a visit once every three to eight months, depending on how your body responds to the treatment. “The good news,” says Dr. Rossi, “is that with some people, the need for Botox diminishes over time and their body sweats less and less. It’s not proven, but anecdotally, it seems to calm the feedback process.”