BOTOX For Palmar Hyperhidrosis

100 Units


Procedure Time: 1 Hr

Recovery Time: Little to None


Sweating is a normal bodily function that everyone experiences. Under normal circumstances, you may experience sweating when you exercise, in hot weather, or a sauna. However, a condition known as hyperhidrosis involves nearly constant sweating. Hyperhidrosis is often localized to bilateral parts of the body, such as the feet, hands, and underarms. When it occurs in the hands, the condition is known as palmar hyperhidrosis. Due to the location and anatomy of the hands, one of the best ways to treat it is with BOTOX injections. Seattle Plastic Surgery provides the best BOTOX for palmar hyperhidrosis Seattle and Tacoma offers.


As mentioned before, hyperhidrosis is a condition that causes excessive sweating of the hands. Typically, most of the sweating occurs on the palm of the hands. This can make daily life and activities difficult and embarrassing. Sweating will usually begin upon waking up or soon after. It may then persist throughout the day.

The condition affects both men and women in equal amounts. Estimates put forth that about one to three percent of the population has palmar hyperhidrosis. While everyone knows what it is like to experience sweaty palms, for people with palmar hyperhidrosis, sweaty palms are an almost constant reality and nuisance.

There is no cure for palmar hyperhidrosis. The condition frequently has no identifiable cause, but genetics do appear to be a factor in hyperhidrosis. Estimates indicate that around 30% of hyperhidrosis patients have a family history of excessive sweating.

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The main symptom of hyperhidrosis is obvious, excessive sweating. This sweating can cause other complications and symptoms. Additionally, temporary excessive sweating or occasional palm sweating may be referred to as hyperhidrosis at times. However, the diagnosable condition is chronic and sometimes occurs incessantly. Along with excessive sweating, other symptoms and complications of hyperhidrosis can include:

  • Clammy hands
  • Staining of clothing and objects you touch (such as paper or the keys of a computer keyboard)
  • Sweating occurs every day (or nearly every day)
  • Excessive sweat localized to the hands
  • Hand/palm sweat not caused by outside factors (such as it occurs even in cold weather or when resting)
  • Disrupts work and daily life
  • Mental distress or anguish
  • Sweat may cause constant dampness of the palms, sometimes sweat may even drip
  • Rashes may appear due to frequent sweating

Motivations For Treatment

Patients with palmar hyperhidrosis, especially those who frequently work with paper or in settings where handshakes are common, become self-conscious or embarrassed of their sweaty hands. It can also make it difficult to perform certain tasks, or even drive. While motivations differ from patient to patient, many palmar hyperhidrosis patients report embarrassment and stress as two important factors.

Other treatments for hyperhidrosis are not always well suited for the hands. Some topical treatments may work for the underarms, but may not provide enough relief from symptoms. Generally, patients and providers find that BOTOX is the most effective solution for palmar hyperhidrosis.

Possible Hyperhidrosis Treatments

Hyperhidrosis has many solutions and treatment options. Patients tend to respond differently to different treatments. Therefore, it can take a while to find the right treatment–or combination of treatments–that provides the best relief from excessive palm sweating.

A list of possible treatments include:

  • Oral medications
  • Topical antiperspirants (including prescriptions strength options)
  • BOTOX/Dysport
  • Iontophoresis
  • Surgery (usually an endoscopic thoracic sympathectomy)

Surgery is usually an absolute last resort. It is normally only considered when other treatments have not adequately treat palmar hyperhidrosis, which is fairly rare. BOTOX has shown to be effective in well over 90% of palmar hyperhidrosis cases.


The more well known uses of BOTOX are for the treatment of dynamic wrinkles and other cosmetic concerns. However, BOTOX also has multiple medical applications, including treating hyperhidrosis. Despite using the same medication, there are some slight differences between the technique and overall treatment of BOTOX for hyperhidrosis. The table below details some of the major differences between cosmetic BOTOX injections and palmar hyperhidrosis BOTOX.

Cosmetic Uses Palmar Hyperhidrosis
  • Average number of units is around 30
  • Primarily treats muscles
  • Inhibits unnecessary muscle movements
  • Injections go past the dermis
  • Lasts about three to six months
  • Addresses aging
  • Usually performed on the face
  • Most people are candidates
  • Not too painful
  • Uses a minimum of 100 units (50 on each hand)
  • Primarily treats nerves/sweat glands
  • Usually has little effect on hand movement after two weeks
  • Shallower injections, typically just under surface of the skin
  • Often lasts six to nine months, sometimes more than one year
  • Numbing usually required

Despite their differences, the two procedures do have some similarities. They each can cause some minor pinpoint bleeding, swelling, and bruising. Though, the side effects following hyperhidrosis BOTOX are generally less severe because they are a shallower injection. Additionally, the way the BOTOX works is largely the same. It blocks signals to the brain to prevent a certain function. In the case of palmar hyperhidrosis treatment, it prevents and stops sweating.


Initial Consultation

When you first come in for your consultation with an injector, they will want to know about your history of sweating. This may include the severity, how it impacts your life, other treatments you have tried, and your goals for BOTOX injections. They may then examine your hands. 

Following this, they will determine if you are a good candidate for palmar hyperhidrosis BOTOX in Seattle. If you are, they will discuss the treatment with you in detail.

BOTOX Injections

Beginning your palm BOTOX injections, your injector will disinfect your hand with alcohol. They will then apply topical anesthetic to sufficiently numb your hand. BOTOX injections are generally not too painful. However, the hand is particularly sensitive due to the high number of sensory neurons in your hands. Even so, patients tend to remain comfortable during treatment.

After these initial steps, your injector then may make markings with a surgical pen. Your injector will then commence with injections. Considering the shallow injections and because BOTOX disperses about a centimeter from each injection site, the injections go quite quickly.

Your injector will use approximately 50 units of BOTOX for each hand. This corresponds to roughly fifty injections across the palm and fingers. Your injector will also customize the injection sites based on your sweating patterns. Typically, the injections address the entire palm and underside of the fingers.

Once injections begin, the treatment usually takes under ten minutes. Your injector may give you ice to hold afterward and will wipe away any present pinpoint bleeding.

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    Aftercare & Results

    Patients can typically return to most of their daily activities immediately. Your injector may advise you not to drink or partake in anything too strenuous for a couple of days. You can also use ice for swelling if needed. Do your best to keep your hands clean and dry.

    It is possible to see some effect of hyperhidrosis BOTOX within a few days. However, it will take up to two weeks for the full effects to settle in. Your injector may want to see you back at this time to evaluate the results of your BOTOX for palmar hyperhidrosis. If sweating is still causing a problem, they may recommend additional units.

    Even if sweating does not go away completely, patients often report an improvement in their quality of life and an overall reduction in sweating. It is possible to use BOTOX injections with other palmar hyperhidrosis treatments like medications and antiperspirants.

    I’ve been coming here for six months and my skin has improved tremendously! Thank you!


    Everyone at seattle plastic surgery is amazing. Angela is great with injections and everyone is very knowledgeable about the best treatments for you. Highly recommend!


    Received Dysport today and it is amazing! 100% will be back.


    This office is wonderful. I have been here for invasive as well as noninvasive procedures and the staff and providers are excellent. They provide a variety of services with the upmost professionalism. Highly recommend.



    How Do I Know If I Have Primary Or Secondary Hyperhidrosis?

    Hyperhidrosis comes in two forms–primary and secondary. BOTOX only treats primary hyperhidrosis, which is hyperhidrosis that has no obvious cause and is usually localized to one area of the body (hands, feet, face, or armpits). Secondary hyperhidrosis tends to occur across larger parts of the body, if not the entire body. It also usually has a cause such as a medical condition or medication.

    BOTOX does not treat secondary hyperhidrosis for two reasons. First, the affected areas are too large to make BOTOX injections affordable and viable. Secondly, treating the cause of secondary hyperhidrosis or prescribing medication will usually resolve the problem. Secondary hyperhidrosis is usually treatable and is not often a chronic condition.

    Do Palm BOTOX Injections Hurt?

    There is some discomfort, yes. While pain is largely subjective, the hands contain a large number of nerves and neurons that respond to touch. This can make it a more sensitive area for treatment. At Seattle Plastic Surgery, we offer topical numbing cream to ease the injections. Our injectors also keep the procedure fairly quick to minimize discomfort.

    How Long Does BOTOX Last For Palmar Hyperhidrosis?

    It depends on the person and the severity of their sweating. In many cases, BOTOX for palmar hyperhidrosis has been shown to last longer than cosmetic BOTOX injections. On average, patients can expect to have BOTOX injections for hyperhidrosis between one and four times per year. Larger doses may allow for severe cases to obtain longer lasting results. 

    Is It Harmful To Stop The Sweating?

    Sweating is a necessary bodily function that keeps us cool. However, the BOTOX injections will only cease sweating at the treatment sites. The rest of your body still sweats normally. This makes it perfectly safe to stop the excessive sweating on the palms.

    What Is The Cost Of Palmar Hyperhidrosis BOTOX?

    For 100 units, the cost of BOTOX for palmar hyperhidrosis starts at $1,300. If you need additional units, this may add to the cost. Seattle Plastic Surgery does work with outside financing companies to make treating your hyperhidrosis affordable. You can find more pricing information on our price list and Price Simulator®.


    Hyperhidrosis is a stigmatizing and debilitating condition that interferes with everyday life. BOTOX is considered one of the best and most effective solutions for palmar hyperhidrosis. When choosing a provider, it is important to choose one qualified to treat hyperhidrosis and with vast experience in cosmetic injectables. At Seattle Plastic Surgery, only our plastic surgeons and aesthetic physicians perform BOTOX for palmar hyperhidrosis. This ensures a qualified provider with a deep understanding of both anatomy and the correct usage of BOTOX. Seattle Plastic Surgery offers the best palmar hyperhidrosis BOTOX Seattle and Tacoma provide.

    Seattle Plastic Surgery is located on First Hill in Seattle. With a calm and friendly atmosphere, our office serves patients with a variety of medical and cosmetic concerns. Bridging the gap between medical treatment and aesthetics, Seattle Plastic Surgery is the top provider of BOTOX for hyperhidrosis in Seattle.

    To schedule a free consultation with an injector at Seattle Plastic Surgery, call us at 206-324-1120. You can also contact us online via Price Simulator®, chat, or contact form.