What is Botulinum Toxin for Sweating? A Guide to Underarm Applications and Excessive Sweating

What is the difference between normal sweating and excessive sweating?

It is normal to experience underarm sweating during hot weather, exercise, stress, or excitement. In excessive sweating, however, sweating:

• May occur independently of ambient temperature.
• Can affect daily tasks and social life.
• May cause noticeable and recurrent wetness on clothes.
• May persist despite the use of antiperspirant products.
• Can limit a person's clothing and color choices.

Diagnosis is not made solely based on the amount of sweat. The onset of sweating, its frequency, the presence of night sweats, and its impact on quality of life are all evaluated together.

In which areas might it be more prominent?

It is most frequently prominent in the underarms, palms, soles of the feet, and the scalp-face area. Its impact on daily life varies by region: palm sweating affects handling paper, keyboards, and handshakes more; underarm sweating primarily impacts clothing choices.

Impact on daily life comfort

Excessive sweating often creates an unnoticed burden: behaviors such as planning outfits, carrying spare items, choosing seating arrangements, and avoiding social environments eventually become habits. Therefore, the assessment considers not only the amount of sweat but also its impact on quality of life.

What is axillary hyperhidrosis?

Axillary refers to the underarm area. Hyperhidrosis is a condition where the body produces more sweat than needed for thermoregulation. Therefore, axillary hyperhidrosis means experiencing excessive underarm sweating to a degree that can affect daily life.

Sweating can often be observed in both armpits. Visible wetness on clothes, the need to change clothes frequently, shyness in social settings, and the constant need to use antiperspirant products can affect a person's quality of life.

Not every instance of heavy sweating is primary hyperhidrosis. A physician should evaluate whether there is another underlying health issue or medication use causing the sweating.

Could there be another reason for underarm sweating?

Yes. Especially if sweating:

• Started suddenly
• Becomes more prominent at night
• Affects the entire body
• Appeared after starting a new medication
• Is accompanied by palpitations, unexplained weight changes, fever, or other symptoms

secondary causes should be investigated.

Thyroid conditions, certain metabolic states, hormonal changes, infections, and various medications can cause increased sweating. In such a case, it is important to evaluate the underlying cause rather than just reducing regional sweating.

Aspects that can provide support in daily life

• Choosing breathable, natural fabrics.
• Keeping the affected area dry and clean.
• Using antiperspirant products as recommended by a physician.
• Observing highly spicy foods and caffeine, which can be triggers.
• Developing breathing and preparation strategies for situations that increase stress.

These aspects can be supportive; medical options are also considered based on the severity of the condition.

What does axillary Botox mean?

"Axillary Botox" and "underarm Botox" are terms commonly used by patients. The medical equivalent of the procedure is botulinum toxin application to reduce excessive underarm sweating.

Botulinum toxin temporarily limits the chemical signals released from nerve endings that stimulate sweat glands. This can reduce sweat production in the applied area.

This procedure does not surgically remove sweat glands and is not a permanent approach. When the effect diminishes, the application can be planned again based on the patient's needs and physician's assessment. Detailed information about the scope and process of the application can be found on the excessive sweating Botox (hyperhidrosis) application page.

Detailed Criteria for Considering Underarm Botox

The application can be considered particularly for adult patients whose underarm sweating significantly affects their daily life and who have not benefited sufficiently from topical antiperspirant methods.

The following information should be evaluated before deciding on suitability:

• Onset time of sweating
• Medications used
• Existing medical conditions
• Pregnancy or breastfeeding status
• Previously applied approaches
• Whether sweating is observed only in the armpits or throughout the body
• Presence of night sweats

This procedure should not be automatically considered suitable for everyone.

What is the Minor iodine-starch test?

The Minor test is a practical evaluation method used to visualize areas of sweating. It is also referred to as the "iodine-starch test."

The test helps map the distribution of underarm sweating. It can be particularly useful for defining the boundaries of the area where injections will be applied.

The test alone does not diagnose the cause of sweating and is not a definitive laboratory measurement. It primarily shows where sweating is concentrated.

Are the Povidone iodine test and the Minor test the same thing?

Patients sometimes search for this procedure as "povidone iodine test." However, the correct and more comprehensive name is the Minor iodine-starch test.

The test is not completed solely by applying povidone iodine. It utilizes the color change created by an iodine-containing solution and starch in the presence of sweat. The physician determines the type of iodine solution to be used and the test protocol.

How is the Minor test performed?

The general application steps for the test are as follows:

• 1. The underarm area is cleaned and thoroughly dried.
• 2. An iodine-containing solution is applied to the test area.
• 3. The solution is allowed to dry.
• 4. A thin layer of starch is sprinkled over the area.
• 5. A dark color change occurs in areas that come into contact with sweat.
• 6. The areas where the color changed are evaluated, and the application area is planned.

Areas of intense sweating may appear dark blue, purple, or nearly black. The boundaries of the color change can help distribute injections based on active sweating areas, not just anatomical estimation.

Is the Minor test painful?

The Minor test is an evaluation applied to the skin surface, not involving injections. It is generally not painful. However, if there is a known sensitivity to iodine or other substances used, the physician should be informed before the procedure.

What should be considered before the test?

Unless the physician recommends otherwise, it may be requested that deodorant, antiperspirant, or cream not be applied to the underarm area before the test. Intense exercise, hot beverages, and excessively warm environments can affect the test result, so it may be necessary to rest for a while before the procedure.

Clinic guidance should be followed regarding when to shave or epilate. The test should not be applied to irritated or compromised skin.

How is axillary botulinum toxin application performed?

After examination and, if deemed necessary, the Minor test, the application area is marked. Botulinum toxin is distributed into the underarm skin with numerous small and superficial injections.

The number of injection points, their intervals, the product to be used, and the dosage are determined by the physician for each individual. The dose units of different botulinum toxin products cannot be directly substituted for one another.

The application requires medical evaluation, appropriate product storage conditions, and correct injection technique.

When does the effect begin?

A reduction in sweating can typically start to be noticed within the first few days after the application. The evaluation of the final response may take longer.

The onset time and the reduction in sweating can vary from person to person. Complete anhidrosis should not be expected in every patient, and a guaranteed definitive result cannot be given.

How long does the effect last?

The effect of botulinum toxin on sweating is temporary. The duration of the effect can vary depending on the person's metabolism, sweating level, application area, product used, and individual response.

Therefore, a fixed duration applicable to everyone cannot be specified. The time for re-application is determined based on the diminishing of the previous effect and the physician's assessment.

What should be considered after the procedure?

After the procedure, patient-specific recommendations should be provided by the physician. Generally, patients may be advised to avoid irritating the application area, intense physical activity, excessively warm environments, and applying products not approved by the physician to the area for a certain period.

Mild redness, tenderness, small bumps, or bruising may occur. If unexpected or severe symptoms develop, the applying physician should be contacted.

What are the possible side effects of axillary botulinum toxin application?

As with any medical application, side effects can occur with botulinum toxin application. Pain, redness, tenderness, swelling, or bruising may be observed in the application area.

Since other side effects related to the product and the individual may also occur, the official product information, the individual's health history, and potential risks should be evaluated by the physician before the procedure.