Treating Under-arm Sweating with ‘Botox’ or ‘Azzalure’: A Quick Guide for Practitioners

Here’s a summary of what we cover on our Foundation course regarding the underarm treatment with Botulinum Toxin Type A:

  • 1 vial Azzalure each side or 50 units Botox each side
  • Explain alternatives (surgery, special deodorant/powders/referral for treatment via the NHS – advise patients to discuss with their GP)
  • Advise no shaving for 48 hours before or after treatment
  • Look where the hair follicles are and mark a “circle” 1cm further out than this. Divide up into 16 sections plus another 2 sections for the tail, going into the deltoid/pec.major/biceps section of the axilla.
  • Divide the volume of BTXA (whichever product) and give equal amounts into each injection site, as superficially as possible for best results.
  • Note, some trainers/courses recommend painting the axillae with iodine then dusting with cornflower, allowing the water in the sweat to transform this into purple patches where sweating occurs – I don’t do this as it makes a big mess and hasn’t given me any better results than the above method
  • If top-up is required, usually the patient can point to where sweating still occurs. If not, use a gloved finger to map out areas where sweating still occurs as follows; if gloves slides over skin, there is no sweat; if the glove “sticks”, there is sweat (whether you can see it with your bare eyes or not)

Whether or not you are “allowed” to perform this treatment is between you and your insurer. I know that some Dentists don’t offer it as they don’t typically treat “below the neck” but Doctors and Nurses don’t usually see the neck as a relevant border for them.