Botox or Botulinum Toxin Type A is a Specialist only treatment for excessive underarm sweating. By having this procedure performed by a recognised HH or hyperhidrosis specialist, you are entitled to a Medicare & PBS rebates.

Botox works by blocking the nerves that transmit the signal to sweat. Here are some facts on the treatment-

1. This treatment takes less than 3 minutes to perform
2. On average patients will have 96% less sweating for up to 6 months
3. Most first time Botox patients will only get relief of up to 4 months
4. Medicare approves 3 treatments per year
5. On average the cost is less than $2 a day – this equates to around $440 per treatment
6. This treatment is very safe
7. You must try Aluminium Chloride (Drichlor or Sesderma) before Botox this is Australia’s Medicare rules. If Driclor causes irritation or does not work, you will qualify for the rebate. In 2020 the stocks of Driclor were low, speak to your pharmacist for an equivalent formulation
8. Specialist treatment of underarm sweating saves you up to $2000 per year, as compared to cosmetic GPs performing this procedure.

Each injection feels like an ant bite, however the majority of patients can and will tolerate this procedure. For patients who want a painless procedure, numbing cream can be applied prior to injections. For super sensitive patients I can use ICE or a skin cooler.

Yes. It is called miraDry. I was the very first doctor in Australia trained in this procedure- back in 2014. miraDry treatment is only suited for excessive underarm sweating and provides a permanent solution for axillary HH.

Botox is not the answer unless you have overseas health insurance. Why? Botox is subsidised for sweaty armpits but not for hands. This treatment cost over $2500 every 3 to 5 months.

The safest treatment is called Glyco Ionto. This uses a special solution called glycopyrrolate that is transferred to your sweat glands using iontophoresis- a highly specialised machine. This sorts out 80-90% of sweaty hands and feet.

Glyco-ionto uses a special machine to deliver a chemical that stops sweating for up to 6 days. See Emily Fenton, nurse practitioner at Skinfluence in the Bayside area for this treatment.

Botox- this is the best solution however, it is not under Medicare for facial areas. Botox last 3-4 months and can only be done on certain areas of the face such as the nose, upper forehead, scalp & under the eyes. The scalp can also respond nicely to Botox injections. Treatment costs vary depending on the areas treated. An approximate guide is between $700- $1800 dollars.

No, I can not pretend to inject it into your armpit & use the rest for your face.

This depends on the sweat areas-

• For sweaty hands and feet, as well as sweat areas on your body, you are best seen in a public hospital as they have iontophoresis devices.
• For sweaty underarms, the treatment of choice is either Botox or ETS- I suggest treatment with Botox first because it is subsidised, and if you are lucky, it may last 8-12 months. For a vascular surgical opinion, Dr Andrew Cartmill in Brisbane is a good choice. If you would like miraDry, the best specialist is Assoc/Prof Phil Bekhor in Melbourne.
• Call up Cutis Dermatology to make a booking with myself for underarm injections. Please note, as per Medicare guidelines, you will require Driclor or equal prior to injections.

Botox injections performed by Specialists in the management of axillary or underarm sweating are partially covered by Medicare. This means patients can claim treatments. The out of pocket cost for treatment is $440. Considering the average user will be sweat free for six to eight months, treatment averages to around $2 a day.

Dr Lim was one of Australia’s first injectors for axillary hyperhidrosis. Under training in Ireland and the UK, he first started performing this procedure in 2001. To date he has performed over five thousand cases. He is also a National trainer in this procedure, and on the advisory board.

He founded Sweat Free- a National society for the treatment of hyperhidrosis.

Apart from Botox, Dr Lim was also the first doctor in Australia to undergo miraDry training overseas- well before the launch of this machine in Australia in 2014.

He is also a leading member of the International Hyperhidrosis Society.

So far patients should know the following facts on sweating-

Excessive sweating of the underarms– best treatment is Botox, followed by ETS.

Excessive sweating of the hands and feet– iontophoresis is best, glycopyrrolate iontophoresis is better. Botox works well but it is very expensive and needs to be repeated every 3-4 months. Unlike Botox for the underarms, this treatment is not subsidised by Medicare. Sweaty hands can be treated with ETS.

Excessive sweating for the face, scalp– Botox is best, but like sweaty hands and feet, it does need to be repeated every 3-4 months, and is not covered under Medicare.

1. Tablets– these can be prescribed by your GP. Ask for Propanthelene Bromide or Oxybutin. These are not specialist tablets and can be obtained at any pharmacist. Ask your GP for a script.
2. Surgery its an option for sweaty hands, face, & underarms. A vascular surgeon performs this procedure. Be warned the chances of compensatory sweating (sweating elsewhere) is unpredictable both in location and probability. Up to 50% of patients will suffer from compensatory HH following ETS surgery, most are mild.
3. CBT- or cognitive behaviour therapy. This treatment can be useful if you suffer from anxiety related sweating. By combining treatments with a psychologist, this can improve your outcomes. Cognitive Behaviour Therapy is an excellent method for reducing stress.
4. Diet– this seems trivial, but if you drink energy drinks or coffee, this will make all forms of sweating worse.
5. Topicals include compounded Glycopyrolate solutions ranging from 1 to 3%. A prescription can be obtained from a medical dermatologist.