30th May 2023

Comparing Popular Hyperhidrosis Treatments: Botox vs Prescription Perspirants

Last Modified: April 30, 2024

Hyperhidrosis, a condition characterized by excessive sweating, is known to affect a notable proportion of the population in the United Kingdom. With an estimated prevalence rate ranging from 1% to 3%, it is a relatively common condition that can significantly impact an individual's quality of life, causing distress, stress, and anxiety.

Excessive sweating associated with hyperhidrosis goes beyond what is considered normal perspiration in response to heat or physical exertion. People with this condition experience excessive sweating even in cool temperatures or without any apparent trigger. It commonly affects specific areas of the body, such as the underarms (axillary hyperhidrosis), hands (palmar hyperhidrosis), feet (plantar hyperhidrosis), or face (facial hyperhidrosis). However, it can also manifest as generalized sweating, affecting larger areas of the body.

The impact of hyperhidrosis on daily life should not be underestimated. Individuals with this condition may constantly worry about visible sweat stains, unpleasant body odor, and social embarrassment. Excessive sweating can interfere with work productivity, personal relationships, and participation in social activities, leading to feelings of self-consciousness, low self-esteem, and even isolation.

Related: Hyperhidrosis and Menopause

Treatment for hyperhidrosis may include lifestyle modifications, such as using antiperspirants, wearing breathable clothing, and avoiding triggers that exacerbate sweating. In more severe cases, medical interventions like prescription antiperspirants, medications, botulinum toxin injections, iontophoresis, or even surgery may be recommended.

This article aims to provide you with a comparison between prescription antiperspirants and Botox injections, helping you make an informed decision that suits your needs best.

As you explore these treatment options for hyperhidrosis, keep in mind the potential side effects and individual results. The key is to consult with a qualified healthcare professional who can guide you toward the most suitable treatment for your condition.

Book a Consultation with Dr Baldeep Farmah

Primary Hyperhidrosis

Primary hyperhidrosis is a form of excessive sweating that is predominantly focal and idiopathic. It typically affects specific areas such as your palms, soles, underarms, or face. This form of hyperhidrosis is not caused by an underlying medical condition or medication use. It can begin during childhood or adolescence and often persists throughout your life.

The exact cause of primary hyperhidrosis is not fully understood, but it is believed to be related to overactivity of your sweat glands, which is possibly due to an issue in your nervous system. Some factors that may trigger or exacerbate primary hyperhidrosis include heat, stress, and emotional situations.

Secondary Hyperhidrosis

Secondary hyperhidrosis is excessive sweating that is commonly generalized and caused by an underlying medical condition or the use of medications. Unlike primary hyperhidrosis, it can affect your entire body rather than specific areas. Some common causes of secondary hyperhidrosis include:

  • Endocrine disorders (e.g., hyperthyroidism or diabetes)
  • Neurological disorders (e.g., Parkinson's disease or stroke)
  • Infectious diseases (e.g., tuberculosis or HIV)
  • Medications (e.g., antidepressants, antipyretics, or anticholinesterases)

To determine the cause of your excessive sweating, it is essential to consult a healthcare professional for appropriate diagnosis and treatment. Depending on the underlying cause, different treatment options are available.

Book a Consultation with Dr Baldeep Farmah

Diagnosis of Hyperhidrosis

It is important to note that hyperhidrosis is a medical condition and should be distinguished from secondary causes of excessive sweating, such as certain medications, hormonal imbalances, or underlying medical conditions. If someone suspects they have hyperhidrosis, it is advisable to consult a healthcare professional for an accurate diagnosis and appropriate treatment options.

Physical Exam

During the diagnosis of hyperhidrosis, your doctor will first conduct a physical exam. This may involve examining the areas of your body where you experience excessive sweating, such as the hands, feet, or underarms. Your doctor will also ask you questions about your medical history and any family history of hyperhidrosis. They may also inquire about any possible triggers or daily activities that cause excessive sweating.

It is essential to rule out any underlying medical conditions that may be causing your excessive sweating. Some common conditions to consider include overactive thyroid, low blood sugar, diabetes, and menopause. Your doctor may recommend further tests or refer you to a specialist if they suspect any of these conditions.

Sweat Test

Sweat tests are vital for assessing the severity of your hyperhidrosis and pinpointing the affected areas. One common sweat test is the Minor or starch-iodine test. This test involves applying an iodine solution to your skin, which turns blue-black when in contact with starch and sweat. This can help your doctor identify the areas of excessive sweating but is not useful for quantifying the degree of your condition.

Another sweat test that may be used is evaporimetry. In this test, a device measures the rate of skin water vapour loss. Evaporimetry can help assess your response to various treatments, such as botulinum toxin injections or topical therapy for palmar hyperhidrosis.

By carefully evaluating your symptoms, medical history, and conducting a thorough physical exam and sweat test, your doctor will be able to diagnose whether you have hyperhidrosis and recommend the most effective treatments for your condition, such as Botox injections or prescription perspirants.

Book a Consultation with Dr Baldeep Farmah

Treatment Options

Prescription Antiperspirants

Prescription antiperspirants contain higher concentrations of active ingredients, such as aluminium chloride, compared to regular antiperspirants. They are applied to the affected areas at night before bedtime and washed off in the morning. Some notable examples include Drysol and Xerac AC. Consult your doctor before using these antiperspirants, as they can cause skin irritation in some cases.

Botox Injections

Botox injections (onabotulinumtoxinA) can be an effective treatment for hyperhidrosis, particularly for axillary, palmar, and plantar regions. The injections block the nerves responsible for activating sweat glands, providing temporary relief for several months. However, you may need to have the injections repeated, as the effects wear off over time.

Oral Medications

Oral medications such as nerve-blocking medications and, to a lesser extent, antidepressants can help manage excessive sweating. Glycopyrronium is an example of a nerve-blocking medication, which has been approved by the U.S. Food and Drug Administration (FDA) to treat hyperhidrosis. It is available in various forms, including Qbrexza, a medicated cloth used to apply the medication directly to the skin.


Iontophoresis involves passing a mild electrical current through the affected areas (usually the hands or feet) while they are submerged in water. This treatment option is particularly useful for palmar and plantar hyperhidrosis, but it requires multiple sessions to achieve optimal results.

Endoscopic Thoracic Sympathectomy

Endoscopic thoracic sympathectomy (ETS) is a minimally invasive surgical procedure that involves disrupting the nerve pathways responsible for excessive sweating. This treatment option is typically considered when less invasive methods, such as antiperspirants or botox injections, have been unsuccessful. ETS can be a permanent solution in some cases, but it carries the risk of side effects like compensatory sweating (increased sweating in other areas of the body) and Horner's syndrome.

Surgical Procedures

Surgical procedures for hyperhidrosis may include excision of the sweat glands or liposuction. These procedures are typically reserved for severe cases where other treatments have failed. Risks associated with these surgical options include infection, scarring, and potential changes in skin sensitivity.

Microwave Therapy

Microwave therapy uses microwave energy to target and eliminate the sweat glands responsible for excessive sweating. It is a non-invasive treatment option, most commonly used to treat axillary hyperhidrosis. The treatment typically requires multiple sessions to achieve satisfactory results. However, as with any procedure, there is the potential for side effects, such as temporary discomfort, swelling, or redness.

By exploring these treatment options and discussing them with your healthcare professional, you can determine the most appropriate course of action for managing your hyperhidrosis.

Treat Your Hyperhidrosis with Dr Baldeep Farmah

Botox Injections vs Prescription Antiperspirants

Mechanism of Action

Botox Injections: Botox, or botulinum toxin, is a neurotoxin that works by blocking the nerve signals that activate sweat glands. When injected into specific areas, such as underarms, hands, feet, or the face, it reduces sweat production by temporarily preventing the release of the chemical responsible for activating the sweat glands.

Prescription Antiperspirants: Prescription antiperspirants typically contain aluminium chloride, which works by obstructing the sweat ducts. By doing so, it reduces the amount of sweat that reaches the skin's surface.


Botox Injections: FDA-approved for primary axillary hyperhidrosis, Botox injections have shown high efficacy and proven to be an effective treatment for excessive sweating. Patients often experience a significant reduction in sweating, even after a single treatment session.

Prescription Antiperspirants: These are generally considered a first-line treatment for hyperhidrosis and can be effective in managing mild to moderate sweating. However, their efficacy may be limited for those with more severe cases, and they are not always effective for treating other areas such as the hands or feet.

Safety and Side Effects

Botox Injections: Botox is generally safe when administered by a qualified professional. However, some side effects may occur, including pain at the injection site, temporary muscle weakness, or flu-like symptoms. In rare cases, the toxin may spread to other areas, causing unintentional side effects.

Prescription Antiperspirants: The most common side effect of prescription antiperspirants is skin irritation, which may include itching or redness at the application site. In some cases, this can be managed by reducing the frequency of application, but for others, it may prove too bothersome.

Duration of Action

Botox Injections: The effects of Botox injections can last between 4 to 6 months, after which sweating may gradually return. Patients may require follow-up treatments to maintain their results.

Prescription Antiperspirants: These products need to be applied regularly, often daily, in order to remain effective.

Cost and Accessibility

Botox Injections: The cost of botox injections range around £400 for both underarms. Insurance may cover the treatment for some patients, but not for everyone. Getting the injections requires visiting a qualified professional, such as a dermatologist.

Prescription Antiperspirants: Prescription antiperspirants are generally more affordable and accessible than Botox injections, as they can be obtained through a prescription from a healthcare provider and applied at home. However, the ongoing need for regular application may make it less convenient for some patients.

Have a Look At Our Pricing for Botox and Other Treatments

Selecting the Best Treatment for Hyperhidrosis

Personal Factors

When considering the best treatment for your hyperhidrosis, it is crucial to take into account personal factors such as the severity of your condition, the affected areas, and any underlying medical conditions. The Hyperhidrosis Disease Severity Scale (HDSS) can help you gauge the severity of your sweating issues. Additionally, conducting a sweat test can provide valuable information to guide your decision.

Your hyperhidrosis may be caused by anxiety or other mental health conditions. In such cases, seeking appropriate treatments like antidepressants or therapy may help manage your sweating symptoms. For sweat issues caused mainly by overactive eccrine sweat glands, nerve-blocking medications like glycopyrrolate can be considered.

Expert Consultation

Consulting a medical expert is essential to determine the right course of action for treating your hyperhidrosis. A thorough evaluation will enable them to recommend the most suitable treatment options, such as Botox injections or prescription antiperspirants.

Botox Injections are a popular choice for managing excessive sweating in targeted areas, like the underarms, hands, and feet. Botox works by blocking the neurotransmitter acetylcholine, which activates sweat glands. This treatment typically requires follow-up sessions to maintain its effectiveness.

Prescription Antiperspirants provide a more targeted solution for excessive sweating. Unlike Botox injections, prescription antiperspirants can be applied to a broader range of body areas, including the face and groin. They work by temporarily blocking eccrine sweat glands, reducing sweat production.

Ultimately, discussing your specific needs and concerns with a medical expert will help guide you in selecting the most effective treatment for your hyperhidrosis. Remember that individual response to treatments may vary, and be prepared to reassess and adjust your approach if necessary.

Book a Consultation with Dr Baldeep Farmah

Why Botox Is The Better Option

As you might know, Botox (onabotulinumtoxinA) works by blocking the release of a chemical called acetylcholine, which stimulates sweat glands. This effectively stops excessive sweating for a certain period of time. In comparison to prescription perspirants, Botox yields better results in managing focal hyperhidrosis, especially in areas like the axillae, palms, soles, and face.

Another aspect to consider is the duration of the treatment's effectiveness. Botox holds an advantage over prescription perspirants as it typically requires fewer applications. While prescription perspirants may need daily application, Botox injections provide relief from excessive sweating for an extended period, usually between 7 to 16 months.

Although Botox injections can be considered expensive, with underarm treatments costing around £400, it is worth noting that the longer-lasting effects can offset the initial expense. Moreover, the side effects of Botox are generally less severe than those of surgical methods, with no adverse events reported in some studies.

Botox's effectiveness isn't limited to underarms only. Despite palmar and plantar hyperhidrosis injections being more painful due to the rich nerve endings in the palms and soles, Botox still demonstrates its effectiveness in these areas, making it a versatile solution for treating focal hyperhidrosis.

In summary, Botox provides a safer, more effective, and longer-lasting alternative to prescription perspirants in managing hyperhidrosis. It is a reliable, non-invasive treatment, and its versatility makes it a valuable option for treating excessive sweating across various parts of your body.

Book Your Botox Treatment for Hyperhidrosis

Post Reviewed by: Dr Baldeep Farmah
Medically Reviewed on: 30th May 2023
Dr Baldeep Farmah is the Medical Director and lead Doctor of Dr Aesthetica, a Medical Aesthetic Clinic.

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