EXCESSIVE UNDERARM SWEATING

Excessive underarm sweating

L’hyperhidrose axillaire primaire est la forme la plus fréquente d’hyperhidrose localisée. Elle se caractérise par une transpiration excessive des aisselles, indépendante de la température extérieure ou de l’activité physique.
Cette condition, fréquente mais souvent minimisée, peut entraîner une gêne sociale, professionnelle ou intime, altérer la confiance en soi et affecter considérablement la qualité de vie. Les vêtements imprégnés, les auréoles visibles, l’humidité constante ou la crainte du regard des autres deviennent autant de contraintes. L’injection de toxine botulique est un traitement efficace et scientifiquement validé pour l’hyperhidrose axillaire primaire. Réalisée par un médecin expérimenté, cette technique permet de contrôler la sudation de manière localisée, durable et naturelle, sans perturber la thermorégulation générale.

Données clés sur les injections de toxine botulique pour l’hyperhidrose axillaire

  • Indication : toxine botulique pour l’hyperhidrose axillaire primaire.
  • Principe : diminution temporaire de l’activité des glandes sudoripares eccrines.
  • Temps de séance : environ 20 minutes.
  • Anesthésie : généralement non nécessaire, pose de crème anesthésiante possible.
  • Début d’action : 2 à 7 jours après les injections.
  • Résultat maximal : environ 2 semaines après le traitement.
  • Durée d’efficacité : 4 à 6 mois.
  • Réduction de la transpiration : généralement 80 à 90 %.
  • Reprise du travail : immédiate.
  • Reprise des activités sportives : attendre 24 heures.
  • Exposition solaire : éviter pendant 24 heures.
  • Prix : 600 CHF le 1er flacon de toxine botulique, 350 CHF chaque flacon supplémentaire.
  • Nombre de flacons : entre 1 à 4. Le plus souvent 1-2 flacons.

Données issues des études cliniques sur les injections de toxine botulique pour l’hyperhidrose axillaire

  • Un essai randomisé multicentrique publié dans le New England Journal of Medicine a montré que 94 % des patients présentaient une diminution d’au moins 50 % de leur transpiration quatre semaines après les injections de toxine botulique, avec une durée moyenne d’efficacité de 6 mois.
  • Les recommandations de l’International Hyperhidrosis Society (IHhS) considèrent les injections de toxine botulique comme le traitement de référence de l’hyperhidrose axillaire primaire lorsque les traitements locaux sont insuffisants, avec un niveau élevé de satisfaction des patients.
  • Une revue systématique publiée dans le Journal of the American Academy of Dermatology (JAAD) rapporte une réduction moyenne de la transpiration comprise entre 80 et 90 %, associée à une amélioration significative de la qualité de vie et des scores de sévérité de l’hyperhidrose.
  • Les publications de l’American Academy of Dermatology (AAD) indiquent que l’efficacité des injections apparaît généralement en moins d’une semaine et dure 4 à 6 mois chez la majorité des patients avant qu’un nouveau traitement ne soit nécessaire.

Contents

Qu’est-ce que l’hyperhidrose axillaire ?

Sweating is an essential phenomenon for the body’s balance. It helps maintain a stable internal temperature, eliminate toxins and protect the skin. It is produced by the sweat glands, located throughout the body, with a high concentration in the underarm area. In some people, these glands become overactive, producing excessive amounts of sweat even when unnecessary. In this case, it is called primary hyperhidrosis. This form of hyperhidrosis is generally idiopathic, meaning without an identified medical cause, but it can be worsened by emotions, stress or fatigue. Unlike secondary hyperhidrosis, it is not linked to a hormonal, metabolic or neurological disease. It often appears during adolescence and persists into adulthood. It is not a serious disease, but it can become very disabling.

photo symptoms excessive sweating

Botulinum toxin : a treatment for primary axillary hyperhidrosis

Botulinum toxin, known for its muscle-relaxing action in the treatment of certain expression wrinkles, also has proven effectiveness in the management of primary axillary hyperhidrosis. Its mechanism of action is based on the inhibition of acetylcholine release, a neurotransmitter essential for activating the sweat glands. When injected locally, botulinum toxin temporarily blocks communication between nerve endings and glands, thereby reducing sweat production. This action is strictly localized, reversible, and does not alter the function of the glands or general thermoregulation. The goal is not to “block” sweating but to modulate it, making it physiologically appropriate. The treatment does not cause compensatory sweating on other areas of the body.
This treatment may be considered occasionally—for example, before an important event where one wishes to avoid any discomfort related to sweating, such as a wedding, job interview, conference or public speaking—or as part of a regular management plan for axillary hyperhidrosis, with sessions repeated twice a year.

Procedure of an underarm botulinum toxin injection session

After thorough disinfection of the axillary area, the doctor performs a series of intradermal injections following a methodical grid pattern. This grid is established from a precise mapping of the sweating surface, allowing the injection points to be evenly spaced in order to target all the sweat glands uniformly. The use of very fine needles ensures a minimally painful procedure, generally well tolerated, requiring neither anesthesia nor special preparation.
No dressing or restrictive care is needed after the procedure. Immediately afterwards, the patient can leave the clinic and resume professional and social activities without downtime, as the treated area usually presents only slight, temporary redness.
The injections themselves take only a few minutes, and if the patient wishes additional comfort, a numbing cream can be applied about fifteen minutes before the injections, although in most cases the simple application of ice packs a few minutes before the session is sufficient to ensure optimal tolerance.

What should be done before underarm botulinum toxin injections ?

Before any injection, a medical consultation is essential. It allows for establishing a precise diagnosis, assessing the intensity of hyperhidrosis, its emotional or functional impact, and ruling out any contraindication. The doctor analyses the extent of sweating, its triggering factors, possible aggravating elements and the patient’s psychological experience. If necessary, additional examinations may be recommended, especially if secondary hyperhidrosis is suspected. This consultation is also an opportunity to define the areas to be treated, explain the treatment mechanism, the duration of its effect, its renewable nature and its possible limitations. Care is always personalised and adapted to each patient.

Botulinum toxin : safety, tolerance and contraindications

Botulinum toxin injections are considered safe and well tolerated when performed in a medical setting and by an experienced doctor. Side effects are rare, temporary and usually mild : slight redness, local sensitivity, small bruises. There is no systemic effect, as the toxin does not act on the rest of the body. Contraindications include pregnancy, breastfeeding, certain neuromuscular disorders and a history of allergy to the toxin. The result is reversible, and the technique can be adjusted according to the patient’s evolving needs and expectations.

Post-session instructions

After injections for axillary hyperhidrosis, no interruption of daily activities is necessary : the patient can immediately resume social and professional life. Slight redness or small bruises may appear, but they remain discreet since they are located under the arms. On the day of the session, it is simply recommended to avoid any friction of the treated area and to refrain from applying potentially irritating products, such as scented deodorants or alcohol-based lotions.

Results

The action of the treatment begins progressively. The first effects generally appear from the fourth day, while maximum effectiveness in reducing perspiration is observed between two and four weeks. At this stage, the decrease in sweating can reach an average of 80 %, leading to the almost complete disappearance of sweat marks and odours related to excessive perspiration.
Once sweating is under control, patients report a significant improvement in their quality of life. Clothing can be chosen freely, social interactions occur without anxiety, and personal confidence is strengthened. Physical, functional and emotional comfort is restored. The sense of control, ease and freedom is one of the most appreciated benefits.
The duration of action is usually around six months. During a first session, it is not uncommon for the effect to be slightly shorter.
Sweating returns gradually, without rebound effect. It is then possible to repeat the injections.

Prices

Le traitement de l’hyperhidrose axillaire par toxine botulique repose sur une approche médicale personnalisée, adaptée à l’intensité de la sudation. Le tarif dépend essentiellement de la qualité du produit utilisé. Le premier flacon de toxine botulique est facturé 600 CHF, chaque flacon additionnel est proposé au tarif de 350 CHF. Lors de la consultation préalable, un plan de traitement personnalisé est établi afin de déterminer avec précision le nombre de flacons requis. Le nombre de flacons requis se situe généralement entre un et quatre.

Conclusion : botulinum toxin for underarms

The injection of botulinum toxin is today the most reliable, precise and non-invasive solution to durably treat primary excessive underarm sweating. It acts locally, blocking the nerve stimulation of the sweat glands without disrupting the body’s overall balance. The results are natural, progressive, reversible and respectful of skin physiology. The treatment enables patients to regain comfort, social freedom and confidence.

Questions fréquentes sur l'hyperhidrose axillaire

Can botulinum toxin injections really stop underarm sweating ?

Yes. Botulinum toxin works by temporarily blocking the nerve transmission responsible for activating the sweat glands. It therefore significantly reduces sweat production in the treated area without altering the body’s overall thermoregulation. The effect is local, targeted and reversible.

The effect appears progressively within the two weeks following the injection. The reduction in sweating generally lasts between six and nine months. The duration may vary depending on each patient, their metabolism and the degree of hyperhidrosis.

The injections are performed intradermally, using very fine needles. The discomfort is moderate and short-lived. A numbing cream may be applied before the session to further enhance comfort.

When used in medical doses and injected by a trained physician, botulinum toxin is a safe treatment, well documented and supported by extensive scientific data. Its use for axillary hyperhidrosis is approved by health authorities and widely recognised.

Yes. The main contraindications are pregnancy, breastfeeding, certain neuromuscular diseases and a known hypersensitivity to the product. The doctor checks these elements during the consultation.

No. The effect is temporary, as botulinum toxin is gradually broken down by the body. The sweat glands then resume their activity. However, it is possible to repeat the treatment once or twice a year, depending on the needs.

Yes, in cases of moderate to severe axillary hyperhidrosis, when local solutions (deodorants, antiperspirants, iontophoresis) are ineffective or poorly tolerated. The treatment provides a significant and long-lasting reduction in sweating, without skin irritation.

It is a precise, non-invasive medical treatment, without social downtime, effective after just a few days and with perfectly controllable results. It provides a reliable, discreet and long-lasting solution for patients bothered by sweating, both socially and professionally.

In the context of a comfort or aesthetic-oriented treatment, botulinum toxin injections for excessive underarm sweating are not reimbursed by health insurance. A personalized quote is provided during the consultation.

Other areas to be treated