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Sweating is your body’s natural way to regulate temperature in a wide range of situations. These situations can vary from when you are exercising, find yourself in a hot environment, or respond to stimuli like stress and anxiety. While sweating under these circumstances is completely normal, if you are one of the 15 million Americans who experiences excessive sweating, a condition known as hyperhidrosis, you may find yourself searching for a solution. Hyperhidrosis can occur in many areas of the body, but one of the most common places for excessive sweating is the palms of the hands. Palmar Hyperhidrosis, which affects 1-3% of the population, can greatly impact the way you live your life. Patients experiencing palmar hyperhidrosis may feel self-conscious about shaking hands, struggle to work in social environments, or be afraid of handling objects or papers due to sweaty palms. Thankfully, there are many treatment options to safely and effectively reduce excessive sweating on your palms.

One of the most exciting innovations in dermatology to treat palmar hyperhidrosis is botulinum toxin injections, more commonly known as Botox®. The Food and Drug Administration (FDA) approved the use of Botox to treat hyperhidrosis in 2004 and ever since, patients have been thrilled with the results of this treatment. When you hear “Botox,” you may think “cosmetic treatment,” as Botox injections are also used to treat wrinkles and maintain healthy, youthful skin. But more and more, Botox being talked about for its safe and effective treatment of hyperhidrosis. Even model and TV personality Chrissy Teigen has taken to Instagram to discuss how Botox helped to treat her excessive underarm sweating. You are not alone if you are experiencing excessive sweating and there are now safe and effective treatments for treating palmar hyperhidrosis and improve your quality of life.

If you are tired of excessive sweating affecting how it affects your life, Dr. Michele Green is here to help. Dr. Green is an expert in Botox treatments, a board certified cosmetic dermatologist in NYC, and a leader in treating both axillary and palmar hyperhidrosis. With over 25 years of experience in cosmetic dermatology, Dr. Green is consistently voted as one of the best dermatologists in New York in Castle Connolly, New York Magazine Best Doctors, and Super Doctors. As one of the “best Botox injectors in NYC,” let Dr. Green help treat your axillary or palmar hyperhidrosis today and enjoy an improved quality of life.

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What is Palmar Hyperhidrosis?

Hyperhidrosis is a medical condition in which the body engages in overuse of its natural regulatory cooling system, also known as sweat. Our bodies are typically excellent at maintaining a set body temperature but, unfortunately, sometimes the nervous system can activate sweat glands too much, and this dysregulation can lead to excessive sweating and discomfort.

Three of the most common forms of Hyperhidrosis are axillary hyperhidrosis, palmar hyperhidrosis, and plantar hyperhidrosis. Axillary hyperhidrosis refers to overactive sweat glands in the armpits, which can be exacerbated due to nerves, physical activity, or a hot and humid climate. Plantar hyperhidrosis is defined as overactive sweat glands on the soles of the feet, and it is sometimes coupled with palmar hyperhidrosis.

Palmar hyperhidrosis refers specifically to sweaty palms or sweaty hands. It’s a common form of hyperhidrosis that typically develops in late adolescence or early adulthood. Most patients realize that they have palmar hyperhidrosis after experiencing an impact to their quality of life, such as difficulty writing due to sweating through paper, or embarrassment when shaking hands. Research is ongoing for palmar hyperhidrosis and hyperhidrosis at large, and Botox injections have become an exciting solution to treat the uncomfortable symptoms of palmar hyperhidrosis.

What causes Palmar Hyperhidrosis?

The most common classification of hyperhidrosis, primary focal hyperhidrosis, is defined by nerves that signal sweat glands too frequently, thus leading to overactive sweat glands and excess sweat. Typically, primary focal hyperhidrosis affects a specific area of the body like the armpits, feet, hands, or forehead and usually worsens with nervousness or stress. Sweating caused by primary focal hyperhidrosis typically occurs symmetrically on each side of the body. Palmar hyperhidrosis is a common part of primary focal hyperhidrosis, which can sometimes be accompanied by sweat on the soles of the feet or the face. Though there is no known cause of primary hyperhidrosis, there is increasing evidence to suggest that there is a genetic component to the condition. More research needs to be done to support this hypothesis but published papers suggest that the development of hyperhidrosis is linked to a dominant gene.

The second type of hyperhidrosis, called secondary generalized hyperhidrosis, is excessive sweating as a result of medical conditions, such as diabetes, nervous system disorders, menopause, certain cancers, and thyroid problems. Secondary generalized hyperhidrosis is characterized by sweating across large areas of the body rather than focused in one specific region. In the case of secondary hyperhidrosis, the primary medical condition should be be addressed to eliminate the excessive sweating. Additionally, certain medications can be a primary cause of hyperhidrosis. If hyperhidrosis is prompted by the use of a new medication, it is important to disclose this information to Dr. Green when you are discussing your treatment options.

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Does Palmar Hyperhidrosis go away?

When seeking a cure for hyperhidrosis, it is important to figure out which type you have, as the type of hyperhidrosis determines how the symptoms will go away. If you are suffering from primary focal hyperhidrosis there is no cure for the condition itself, rather treatment focuses on eliminating the symptoms. Primary focal hyperhidrosis affects specific areas of the body like the underarms, hands, feet, and face and so treatment will be focused on reducing or eliminating sweat in those areas.

Secondary generalized hyperhidrosis, on the other hand, is caused by an underlying medical condition such as diabetes, leukemia, anxiety/stress, hormonal fluctuations, or an infectious disease. Excessive sweating can occur as a side effect of these conditions and if that is the case, it is important to address the health condition in order for the hyperhidrosis to go away. Secondary generalized hyperhidrosis can also occur as a side effect of medication that you are taking. If you are finding that is the case, you can consult with your physician about switching your medication or with Dr. Green about treating options for treating the excessive sweating.

Regardless of the cause, Dr. Green will meet with you to discuss your specific condition and make a determination about which treatment method is right to address your needs. There are many different treatment options ranging from topical antiperspirants to oral medication to other procedures such as Botox. Dr. Green will prescribe these treatments individually or in combination to treat your excessive sweating.

How to Cure Palmar Hyperhidrosis

If you’re wondering how to get rid of palmar hyperhidrosis, there are several treatment options. Common initial treatment of focal hyperhidrosis includes prescription antiperspirants and prescription creams, which are designed to build salt clogs which can stop sweat from reaching the surface. In addition, topical aluminum chloride, nerve block-based medications, and anti-depressants can all be used to treat hyperhidrosis. Another treatment for more moderate palmar hyperhidrosis is iontophoresis, which uses a low-intensity electrical current to reduce the amount of sweating in target areas.  Though these treatments are successful for some, many patients have inconsistent results, and almost all of these treatments require a considerable amount of upkeep.

In severe cases of palmar hyperhidrosis, patients may choose endoscopic thoracic sympathectomy (ETS), which is an invasive surgical treatment intended to permanently interrupt certain nerve signals to eccrine (sweat) glands. However, this treatment has severe side effects, including but not limited to: compulsory sweating all over the body, arrhythmia, heat intolerance, and hypotension. Due to these risks, any decision to engage with ETS should be made with extreme caution.

For many patients, the journey for how to stop palmar hyperhidrosis ends with Botox injections. Botox treatment of palmar hyperhidrosis is an ideal option for those looking for consistent relief of sweaty palms. Current research shows that Botox treatment is 80-90% effective in relieving the symptoms of palmar hyperhidrosis, and Botox can be combined with other treatments to eliminate excessive sweating from the palms. These combination treatments are typically preferred over more invasive treatment options. When determining which treatment option is right for you, it is important to consult with a board-certified dermatologist such as Dr. Green.

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Does Botox work for Hyperhidrosis?

When you think of Botox, your brain likely jumps first to cosmetic surgery but when patients ask, does Botox help hyperhidrosis, the answer is yes! Botox, named for botulinum toxin type A, is a neurotoxin that halts signals to nerve endings. This process was initially developed by Allergan for use in muscle disorders, and shortly thereafter became a popular for cosmetic use in the world of cosmetic dermatology and plastic surgery for treating fine lines and wrinkles. Dr. Green is an expert platinum Botox injector in NYC and quickly expanded her use of Botox from cosmetic indications to treating patients suffering from hyperhidrosis.

When it comes to skincare, Botox is typically used to freeze muscles, thus reducing the appearance of fine lines and dynamic wrinkles. In the case of hyperhidrosis, Botox is able to interrupt the nervous system’s overactive use of sweat glands as a cooling system for the body. Botulinum toxin therapy will essentially “freeze” sweat glands at or near the injection site, thus reducing excessive sweating and improving your quality of life.

Does Botox work for Palmar Hyperhidrosis?

Yes! Botox treatment for hyperhidrosis has proven to be extremely successful for patients suffering from excessive sweating on their palms and/or hands. Since Botox is not a permanent treatment and lasts approximately six months when injected in this area, it is recommended to repeat Botox injections on a six-month cycle for optimal results. Botox treatment of palmar hyperhidrosis is an excellent non-invasive method to provide long-lasting relief from sweaty palms.

The procedure itself is quick and relatively painless. Typically, the process requires using a topical numbing cream one hour before injections, and if a patient is particularly sensitive to pain, nerve-blockers may be recommended for the duration of the treatment. Generally, 20-30 ultra-fine, small needles are used to inject Botox into each palm, and the process takes only about 15 minutes in all. As this treatment is an advanced Botox injector technique, it’s critical that you work with a board-certified medical professional who has experience with Botox injections for hyperhidrosis. Dr. Green is an expert in Botox injections for both cosmetic and medical use, and the safety and satisfaction of her patients is her top priority for any Botox treatment.

After treatment, the most common side effects are mild muscle weakness (a looser grip), and occasional bruising. Most patients leave their appointment requiring no downtime. Relief from excessive sweating is usually in full effect one to two weeks following treatment. has published several studies to determine the effectiveness of the Botox treatment for excessive sweating and in particular, palmar hyperhidrosis. Patients who participated were randomized–meaning patients participating in the study were randomly chosen to either receive the full Botox treatment or an alternative treatment–and either single-blind–meaning while patients knew that in the study they would be getting some sort of treatment for hyperhidrosis, they were not told what specific treatment they were receiving–or double blind–meaning the researcher also was not told which treatment the patient was getting until after the trial was complete. Randomization and single- or double-blindness is important in clinical studies to decrease the likelihood of biased research results. These studies published by PubMed in their neurology section have shown that Botox is effective in significantly reducing sweating on the palms for up to 6 months following the treatment with limited side effects. (DOI: 10.1212/wnl.57.11.2095)

How common is Palmar Hyperhidrosis?

Sweating is very normal, and most people will find that their palms get sweaty in a variety of situations such as engaging in intense physical exercise, spending time in a very warm environment, or in a nerve-wracking situation like giving a speech in front of a large group of important people. But for those suffering from palmar hyperhidrosis, severe sweating occurs on the hands and/or palms outside of these normal situations. Excessive sweating can happen when you are just sitting at your desk doing work or in a regular social situation and can cause distress or embarrassment. It does not help that palmar hyperhidrosis is exacerbated in stressful situation. When you’re suffering from this condition, it is easy to feel alone but in reality, there are millions of Americans that deal with hyperhidrosis of the palms or hands. In fact, it is estimated that 1-3% of the population suffers from palmar hyperhidrosis. Sometimes, that lonely, embarrassed feeling can keep people from seeking treatment for the condition. But Dr. Green is here to make you feel comfortable throughout the whole hyperhidrosis treatment process and with procedures like Botox for palmar hyperhidrosis, your hands will be feeling dryer within 2-4 days of receiving treatment.

How long does Botox last for Palmar Hyperhidrosis?

As Botox injections are nonpermanent, the results of Botox for palmar hyperhidrosis are also, unfortunately, temporary. However, many patients find that the relief from excessive sweating thanks to one Botox injection treatment can last upwards of six months. For optimal and continual relief from the symptoms of hyperhidrosis, Dr. Green recommends patients continue with routine Botox injections spaced six months apart.

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How many units of Botox for Palmar Hyperhidrosis?

Each patient is unique, which is why Dr. Green will take your specific needs and condition into account before determining the units necessary for treatment. On average, patients require a minimum of 100 units of Botox for a single treatment, into both palms. Depending on the size of one’s palm, 0.1 cc aliquots of Botox are injected in 20 to 30 discreet areas of the hand. The injections are spaced approximately 1 cm apart within the areas which are hyperhidrotic. After the first treatment is complete, Dr. Green will ask patients to return after two weeks for a follow-up appointment so Dr. Green can check the treatment area and provide any additional injections as needed.

How to inject Botox for Hyperhidrosis

The process for receiving the Botox treatment for palmar hyperhidrosis is simple–the procedure does not take long and there is no downtime required after the process. You will begin by meeting with Dr. Green to discuss your particular condition of primary palmar hyperhidrosis and determine the number of units of Botox necessary for your treatment. To prepare the area before the injections, Dr. Green will apply a numbing cream or localized anesthetic to reduce feeling in your hand and minimize pain and discomfort. Then, Dr. Green will inject the botulinum toxin (on average 100 units total) in 20 to 30 spots on your palm. The injections serve to block the cholinergic nerve cells release of acetylcholine, which is a neurotransmitter responsible for sweat production. The treatment itself does not take long to complete and there is no downtime, meaning you can return to your regular activities right after the procedure. You should start to see results 2-4 days following the treatment. About 2 weeks after receiving the Botox treatment, you will schedule a follow-up where Dr. Green will assess the treatment area and provide any touch ups if necessary. Reduced sweating in your palms can last up to 6 months and the Botox treatment can be repeated for continued dryness.

Is Botox safe for Hyperhidrosis?

Yes! Botox is both safe and effective for treating palmar hyperhidrosis when the treatment is done by an experienced and expert dermatologist like Dr. Green. The procedure itself is relatively painless and there is no downtime necessary following the treatment, meaning you can return to your regular activities immediately. There are very few potential side effects, which include bruising and muscle weakness in the hands. Further, there is very little evidence to support that the treatment leads to compensatory sweating elsewhere in the body. In other words, there is minimal risk that your body will compensate for the lack of sweating in your palms by sweating in other areas of your body. That said, Botox treatment is a very delicate procedure, and the risk of potential side effects decrease significantly if you go through the process with a board-certified dermatologist like Dr. Green as opposed to a nurse at a Spa treatment facility.

How much does Botox for Palmar Hyperhidrosis cost?

Many patients ask how much is Botox for hyperhidrosis of the hands? When evaluating the cost of Botox for palmar hyperhidrosis, it’s important to consider how many units of Botox will be necessary to treat the palmar hyperhidrosis. The amount of Botox needed is dependent on individual factor, and the needs of each patient. Men typically have larger hands and stronger muscles than women and require more units of Botox per area. While the average number of units necessary is 100, patients may require more or less depending on your condition and the size of your hand.

The cost of Botox for palmar hyperhidrosis also depends on the experience of the treating injector. A board-certified expert injector will be more expensive than a nurse injector or medispa. It’s important to note that getting the procedure done by an experienced expert, such as Dr. Green, has been shown to greatly reduce the risk of possible side effects of the procedure. Botox to treat palmar hyperhidrosis is a delicate procedure that is best performed by an expert dermatologist like Dr. Green, who has many years of experience performing Botox.

As hyperhidrosis is a medical condition, Botox may be covered by insurance, though typically this is dependent on several factors. First, the severity of the hyperhidrosis must be determined by a medical professional. Additionally, many patients are required to use at least two other treatment options before receiving coverage for Botox. If you think you may be eligible for coverage for Botox treatment of palmar hyperhidrosis, talk to your insurance company directly to see what documentation is required.

How do I get started with Botox injections for my hyperhidrosis?

If you suffer from excessive sweating, sweaty palms or axillary hyperhidrosis, Botox treatments, by Dr. Michele Green in NYC, can offer you immediate relief. With over two decades of experience with Botox injections, Dr. Green was one of the first dermatologists in New York to incorporate Botox in her private Upper East Side New York practice. To schedule a consultation for Botox injections and eliminate palmar hyperhidrosis, axillary hyperhidrosis, or plantar hyperhidrosis, please call us today at 212-535-3088 or contact us online. Dr. Michele Green and her staff will help you on your journey to eliminate sweaty hands, palms, or underarms, and live a more comfortable, confident life.

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