Northwest Face & Body

Procedure Time

1 Hour

Recovery Time

Little To None

Botox for Palmar Hyperhidrosis

BOTOX–while more frequently associated with the treatment of fine lines and wrinkles–also treats some medical concerns and conditions. Originally developed to treat certain muscle disorders such as eye turning and involuntary spasms, cosmetic applications were discovered during clinical trials. This led to the BOTOX we are most familiar with today. However, a lesser known condition that BOTOX injections can treat is hyperhidrosis, also known as excessive sweating. Northwest Face & Body provides the best BOTOX for palmar hyperhidrosis Bellevue and Kirkland can offer.

Hand Sweating vs. Palmar Hyperhidrosis: What It Means

Hyperhidrosis is a condition that causes almost constant, excessive sweating. The main type of hyperhidrosis–primary hyperhidrosis–tends to affect certain areas of the body. Among one of the most frequently afflicted areas are the palms. Known as palmar hyperhidrosis, this condition causes excessive, sometimes incessant sweating on the palms and undersides of the fingers. It almost always is present on both hands and episodes happen at least once a week.

Palmar hyperhidrosis is one of the most common presentations of primary, or focal, hyperhidrosis. People with the condition often feel embarrassed when having to shake hands or because they stain clothing or objects they touch. While not a dangerous or severe condition, hyperhidrosis can interfere with everyday life enough that it requires medical attention.

History Of Hyperhidrosis Treatment

Humans have always sweat. However, only in the past couple of hundred years have humans began to understand what causes sweating and sweating disorders. There is evidence of palmar hyperhidrosis and other forms of hyperhidrosis throughout history. In the Victorian era, a character in a Charles Dickens novel leaves sweat stains on the pages of a book.

What became obvious from these historical accounts is that hyperhidrosis was stigmatized. This is still true today. While better understood and less stigmatized, sweat stains can lead to assumptions about hygiene. This can cause embarrassment and social isolation.

Before the 20th century, effective treatments for hyperhidrosis did not exist. People with hyperhidrosis either had to live with the condition, use remedies that may only work for a short time, or solutions that only had a minimal result. In 1899, the first sympathectomy was performed, but not for sweating. It would not become the surgical treatment for hyperhidrosis until 1920. Throughout the 20th century, hyperhidrosis treatment options, including sympathectomy, became less invasive and more effective.

Treating Palmar Hyperhidrosis In The 21st Century

Today, only in rare or extreme cases do patients undergo surgery to treat hyperhidrosis. The first recommended treatments are usually BOTOX and prescription medications and antiperspirants. BOTOX first gained approval for treating hyperhidrosis in 2004. Since then, it has become one of the most effective treatments for focal hyperhidrosis today.

Additionally, while the cause of hyperhidrosis is still not fully known. Secondary hyperhidrosis–which tends to affect either the entire body or larger areas–is normally caused by health conditions or medications. Therefore, this type of hyperhidrosis can be treated more effectively with modern medicine.


Sweating occurs when the nerves in the afflicted area send signals to the brain. The brain will then activate the sweat glands which results in sweating. In someone with hyperhidrosis, the nerves are sending too many signals, which is why they experience excessive sweating.

BOTOX is made of the neurotoxin, Botulinum toxin type A. When injected in small amounts into the sweat glands and surrounding nerves, it temporarily blocks these excessive signals to prevent and reduce sweating. Some patients may see a complete cessation in sweating while others a significant reduction. Regardless, BOTOX often improves the quality of life for people with hyperhidrosis.


BOTOX for palmar hyperhidrosis has many benefits. The benefits experienced will vary from patient to patient based on the severity of their condition and goals. In general, the benefits of BOTOX for hyperhidrosis treatment include:

  • Reduction or cessation of sweating in the treated area
  • Few side effects (due to shallower injections)
  • Little risk
  • Safe procedure
  • Does not require daily maintenance
  • Injections only take about ten to twenty minutes
  • No downtime required
  • Improved mental health
  • Less need to make accommodations in work or social life
  • Reduced embarrassment about their sweating palms
  • Non-invasive procedure

Palm BOTOX Before And After


BOTOX for palmar hyperhidrosis is not a cosmetic use of BOTOX that most healthy people are a candidate for. You will need to come to Northwest Face & Body for an initial consultation before scheduling your injections. You will meet with one of our plastic surgeons or aesthetic physicians. They will ask you some questions about your history of hyperhidrosis, treatments you have tried, other aspects of your medical history, and goals for treatment.

Finally, they may want to know about elements of your lifestyle such as if you smoke. Your injector may then perform a brief examination of your palms and hands. If they determine you are a good candidate, they will describe your personalized care plan. You can then schedule your BOTOX for palm hyperhidrosis injections.


Your provider will start the procedure by disinfecting the underside of your hands with alcohol. They will then likely apply topical numbing cream. While hyperhidrosis BOTOX injections are shallower than for wrinkles, the palms are an especially sensitive area. Therefore, most patients opt for numbing cream before the treatment to keep the process comfortable. Luckily, once injections begin, the procedure usually takes less than twenty minutes.

Your injector may mark the injection sites. In the average palmar hyperhidrosis treatment, there are roughly thirty to fifty injection sites with just over a unit or about a unit injected at each. BOTOX spreads out about a centimeter from each injection site. Furthermore, you can expect the injections to be about that far apart.

Traditionally, for your first hyperhidrosis BOTOX treatment, your injector will start with one hundred units of BOTOX, fifty on each side. After two weeks, your injector will evaluate the results to determine if more units are necessary.


After your palm BOTOX, you can return to work and activities right away. You will want to refrain from any activities or environments that may cause natural sweating, including exercise. This prevents infection, bruising, and displacement of the BOTOX. Your injector may also recommend avoiding alcohol and certain pain relievers because they can worsen or cause side effects.

Patients usually do not feel too much discomfort after their injections. The day of and the day following the procedure some patients may find taking Tylenol and icing the palms helpful. Some patients may experience mild side effects such as swelling, bruising, redness, and itchiness. On rare occasions, stiffness or difficulty moving the hand can occur. Major side effects or complications are rare. Most side effects should subside within two weeks.

Frequently Asked Questions

Are You Born With Hyperhidrosis?

People typically do not see the onset of hyperhidrosis until between the ages of thirteen and twenty-five. While childhood hyperhidrosis can happen, it normally has another cause. The condition tends to start around puberty or young adulthood in most patients.

Is There A Permanent Solution?

Surgery remains the longest lasting and most permanent solution for hyperhidrosis. However, surgery is typically not the preferred fix because it is a fairly sensitive procedure. It does not guarantee to stop sweating. The surgery is also not always permanent, and sometimes sweating can start in another area in response.

Therefore, there is no guaranteed, permanent cure for hyperhidrosis. However, both BOTOX and surgical procedures tend to have the highest rate of success. BOTOX comes with much less risk than surgery and offers relief for the majority of hyperhidrosis patients.

How Long Can I Expect BOTOX For Hyperhidrosis To Last?

BOTOX for palmar hyperhidrosis does tend to last longer than cosmetic BOTOX. This is largely because it is not injected into the muscle which is constantly moving. However, like cosmetic BOTOX injections, the amount of time BOTOX hyperhidrosis treatment lasts will vary from person to person.

On average, patients can expect their results to last between six and twelve months. Some patients may even see as long as fifteen or sixteen months. On the other end of the spectrum, some patients may see their results last less than six months. Though, this is fairly uncommon for hyperhidrosis treatment.

Does BOTOX Work On Everyone?

BOTOX does reduce sweating for most hyperhidrosis patients. However, there is a small percentage that may see no change in their sweating after BOTOX. Usually, this is in especially severe cases. It is possible to build a tolerance for BOTOX. This is not seen as often with BOTOX for hyperhidrosis, but is possible. In these cases, another neuromodulator like Dysport can be used.

For people suffering from hyperhidrosis, BOTOX is worth a try. It is a relatively non-invasive treatment and offers the chance to cease or reduce sweating for several months. Additionally, some patients may simply require additional units to see the best results.

How Much Is BOTOX For Palm Sweating?

At Northwest Face & Body, 100 units of BOTOX for hyperhidrosis treatment costs $1,300. If more BOTOX is needed, this may result in additional costs. This covers the entirety of the procedure including the BOTOX and the fees for the injections. Northwest Face & Body also works with two outside financing companies, Care Credit and United Medical Credit.

Stop Sweaty Hands With BOTOX Injections In Bellevue And Kirkland

Sweaty palms may seem like a harmless condition. However, when it occurs in excess like with palmar hyperhidrosis, it can severely interfere with every aspect of life. BOTOX is among one of the most effective treatments for hyperhidrosis. Northwest Face & Body provides the best BOTOX for palmar hyperhidrosis in Bellevue and Kirkland.

The injectors at Northwest Face & Body consist of plastic surgeons and aesthetic physicians who are all trained in hyperhidrosis treatment. Having treated hyperhidrosis on the palms, feet, face, and underarms, they are among the most experienced BOTOX injectors in Washington State.

To schedule a consultation with one of our top injectors, call us at 425-576-1700. You can also connect with us online via Price Simulator®, chat, or contact form.