Botox 101: How It Works, What it Costs, & How it Can Help Sweaty Palms

by Stephen Prendiville, MD, Assuage Centers, Fort Myers, FL

From how it works, to what it costs, to how it can help with excessive sweating. Dr. Prendiville of Assuage Centers shares some important information about Botox!

How does botox work?

My explanation to patients is that Botulinum toxin (Botox) prevents the nerve and muscle from “talking to each other.” It works by preventing the release of a neurotransmitter, known as acetylcholine from the neuromuscular junction, giving the patient a temporary “wrinkle-free” result that will last for up to 3 months. Most patients will use Botox for the hyperdynamic lines, often called “worry lines” or “frown lines,” in the upper third of the face for cosmetic purposes. These lines are formed in the skin due to repetitive muscle action in those areas and a common area to use the injectable that is approved by the FDA for cosmetic purposes is the glabella, often referred to as the “11s” (the lines made when a person furrows their eyebrows). However, Botox is often used to treat horizontal forehead lines and crow’s feet as well and less commonly it’s used for the vertical lines around the lip, but is risky due to the possibility of temporary loss oral continence.

What can Botox do for sweaty glands?

Botox is not just for cosmetic purposes but is also a great option as a temporary treatment for hyperhydrosis, or excessive sweating, often experienced in the armpits and palms. The reason for this is that the receptor that activates the sweat gland is very similar to the one that exists between motor nerves and muscles (in the forehead, crow’s feet, and glabella). My personal experience is that Botox lasts longer when used for this indication than it does for hyperdynamic facial lines, lasting up to 6 months.  In this instance, Botox is administered via multiple shots with a very small needle to the skin of the affected area. My experience is that patients will generally require about 100 units (for both armpits) to achieve a result they are happy with. As with other indications for Botox, the result takes 3-7 days to become obvious.

How much does Botox cost?

The cost of Botox is dependent on units and the results are, in medical terms, “dose dependent.” This means that the greater dose administered, the more profound the result will be. I have found it more useful, and more straightforward for the patient, to charge by the unit. The typical cost of Botox in my area is $15-$20 per unit. For treatment of a single area such as the glabella, the average dose is roughly 20 units, depending on the level of activity, muscle strength, etc., of the individual patient.