Botox for
Excessive Sweating (Hyperhidrosis) in Dubai

Underarms: the licensed use

Botox has been approved since 2004 for severe primary axillary hyperhidrosis that topical treatment has not controlled. The labelled dose is 50 Units per underarm, injected intradermally in 10 to 15 points about 1 to 2 cm apart across the area that the starch-iodine test shows. In the licensing trials about 80 percent of treated patients improved by two points on the Hyperhidrosis Disease Severity Scale, against about 35 percent on placebo, and the median time before sweating returned was 201 days. Our standard visit treats both underarms.

Why we map before we inject

The sweating area rarely matches the hair-bearing skin. Painting the underarm with iodine and dusting it with starch turns the sweating skin dark within about ten minutes, so the injections cover the glands that matter and no dose is wasted on dry skin. We repeat the map at follow-up when a patch keeps sweating.

Palms and soles

Palmar and plantar hyperhidrosis are off-label uses. Published reports give palms 80 to 90 percent effectiveness, but the hands need many more injections, discomfort is higher, and temporary weakness of grip or fine finger movements can last for weeks. Soles respond less predictably and satisfaction is lower. We treat palms only after discussing these effects and only when antiperspirants and iontophoresis have failed or are unsuitable.

Face and scalp

Sweating of the forehead and scalp can also be treated off-label, with results lasting about four and a half months in the AAD's summary. Forehead injections can weaken nearby muscles and cause temporary eyebrow asymmetry, so the dose and placement follow a separate assessment.

What the result looks like

Sweating falls within 7 to 10 days and is usually at its lowest by two weeks. The treated skin becomes dry rather than numb; sensation and hair growth are unchanged. When the effect wears off, sweating returns to its previous level; it does not rebound worse. Some patients notice slightly more sweating elsewhere, which the label lists as non-axillary sweating.

Before botulinum toxin

The NHS and the American Academy of Dermatology both start with clinical-strength aluminium-chloride antiperspirants applied at night to dry skin, then iontophoresis for hands and feet. Prescription anticholinergic wipes and oral medicines exist for widespread sweating but cause dry mouth and blurred vision in some people. We ask what you have already tried before recommending injections.

Ruling out a cause

Secondary hyperhidrosis follows another condition or a medicine. Medical laboratory tests for thyroid function, glucose and infection markers are arranged when your history suggests one; treating the cause can remove the need for injections. A dermatologist consultation is the right starting point when the pattern is unusual.

Permanent options

Microwave thermolysis destroys underarm sweat glands permanently and surgical sympathectomy interrupts the nerve supply; both carry risks of their own, including compensatory sweating after surgery, and neither is offered at our clinic. Botulinum toxin is temporary and adjustable, which many patients prefer as a first step.

Laser hair removal of the underarms

Soprano laser hair removal does not reduce sweat, but a hair-free underarm reduces odour-causing bacteria and makes mapping and injections easier. We schedule laser and injections on separate days.

Other botulinum toxin treatments

Cosmetic Botox for expression lines, neck band treatment and migraine assessment use the same medicine for different reasons, with their own doses and risks. A sweating consultation does not establish that another area needs treatment.

Before your appointment

Shave the underarms 12 to 24 hours before, not on the day, so the skin is calm. Do not apply antiperspirant or deodorant on the day: it interferes with the starch-iodine map. Avoid alcohol and strenuous exercise for 24 hours. Tell us about every medicine and supplement, especially blood thinners, aminoglycoside antibiotics and muscle relaxants, which interact with botulinum toxin. Do not stop a prescribed medicine on your own.

Bring details of any previous botulinum toxin treatment: date, product, dose and how long it lasted. That history sets the starting dose for your next visit.

After your appointment

Leave the area alone: no rubbing, massage or tight straps for the rest of the day. Skip deodorant for 12 to 24 hours and avoid hot showers, sauna, steam and heavy exercise for 24 hours. Small red points or bruises fade within days. You can work, drive and shower normally.

Review and repeat treatment

We review the result at about two weeks, when the effect is at its peak; a remaining sweating patch can be mapped and topped up then. Repeat treatment is planned when sweating returns to a level that bothers you, typically between 4 and 12 months. Each repeat is a fresh decision on dose and area, not an automatic booking.

Our products and clinical process

Evolution Aesthetics Clinic holds DHA Polyclinic License 6000514. Our doctors work within their licensed scope and approved clinical privileges, assess you face to face and give every injection themselves. We use authentic botulinum toxin products authorized for use in the UAE, bought through official, authorized suppliers, and follow the required storage, reconstitution and handling instructions. You receive written aftercare and a review appointment, and we are happy to show you the paperwork.

Underarm treatment is a licensed use of Botox. Palms, soles, face and the other botulinum toxin products are off-label for sweating; where that applies we explain what it means and the evidence before you decide.

Common and less common effects

The label reports injection-site pain and bleeding, sweating elsewhere on the body, infection, sore throat, flu-like symptoms, headache, fever, neck or back pain, itching and anxiety in 3 to 10 percent of trial patients. Bruising and tenderness are common for a few days. Palm treatment can weaken grip temporarily; forehead treatment can cause eyebrow asymmetry. Tell us promptly about any unexpected or persistent symptom.

When to get immediate help

Botulinum toxin can, rarely, spread beyond the injected area. Get immediate medical help for difficulty breathing, swallowing or speaking, drooping eyelids, double vision, marked muscle weakness or loss of bladder control, even weeks after treatment. Swelling of the face or throat, hives or wheezing need emergency care. Do not wait for a routine clinic reply.

When treatment may be unsuitable

We do not inject through infected, irritated or inflamed skin, after recent surgery or a wound in the area, or when you are allergic to botulinum toxin or its components such as albumin. Pregnancy and breastfeeding, neuromuscular disorders such as myasthenia gravis, Lambert-Eaton syndrome or ALS, aminoglycoside antibiotics or certain muscle relaxants, and bleeding disorders or blood thinners all need review and may mean postponing treatment. We also postpone when the sweating pattern suggests an untreated medical cause.

Our Botox safety and side-effects guide explains these questions in more detail, and botulinum toxin brands and types explains the product differences.