Atlanta (Buckhead)
3833 Roswell Rd NE, Tuxedo Atrium, Suite 108Atlanta, GA 30342
Floor 1 of the Tuxedo Atrium
Monday to Friday 8:30 AM to 5 PM; Saturday 8:30 AM to 2:30 PM
Medical Botox
Botox for Underarm Sweating in Buckhead and Cumming
Botox for excessive underarm sweating is an FDA-approved use: the label covers severe primary axillary hyperhidrosis in adults that topical agents have not managed. Injected into the skin, Botox temporarily blocks the nerve signal to the sweat glands. In the label's first trial the median response lasted 201 days. Other body areas, such as the palms, are not approved uses.
- 608 Google reviews, rated 4.9 and 5.0
- Board-certified physician who treats every patient herself
Treated by Dr. PaymanBuckhead and Cumming
What it treats
What does Botox for excessive sweating treat?
Botox for sweating treats severe primary axillary hyperhidrosis: heavy underarm sweating with no underlying medical cause that interferes with daily life and has not been controlled by topical agents. The FDA label approves it for adults, for the underarms only. Use on other areas, such as the palms or face, is not an approved use.
Hyperhidrosis is sweat production beyond what the body needs to cool down. A 2019 review in the Journal of the American Academy of Dermatology estimated that it may affect at least 4.8% of the US population and that about 93% of cases are primary, meaning not caused by another disease or a medication.
The Botox label explains the mechanism: injected into the skin, Botox produces temporary chemical denervation of the sweat gland, with a local reduction in sweating. The label's limitations of use say safety and effectiveness in other body areas have not been established, and that hand weakness and eyelid drooping may occur when it is used for palm and face sweating. This page covers the underarms.
Results
Does Botox for sweating really work, and how long does it last?
In the label's two placebo-controlled trials, most treated adults had at least a 50% drop in underarm sweat, and the effect wears off. In the second trial that was 91% of treated adults at four weeks, versus 36% with placebo. In the first trial the median response lasted 201 days, and the AAD says one treatment can give up to six months of relief.
The evidence in detail
In the first trial, 81% of adults given the labeled dose had a drop of at least 50% in sweat production at week 4 versus 41% on placebo, and 55% versus 6% met the label's responder definition, an improvement of two or more grades on the 4-point Hyperhidrosis Disease Severity Scale, judged after the first two treatment sessions. The label says repeat injections are given when the effect of the previous one diminishes, and the AAD says a single treatment can provide up to six months of relief. Results vary from person to person, so ask Dr. Payman what to expect.
Is it right for you?
Who qualifies for Botox for sweating, and who should wait?
You may qualify if your underarm sweating is severe, interferes with daily life, has not been controlled by topical products and a physician has ruled out another cause. Wait, or ask first, if you are pregnant or breastfeeding, are under 18, have a skin infection in the area, are allergic to a botulinum toxin product or have a nerve or muscle disease.
The label's trials enrolled adults who rated their sweating 3 or 4 on a 4-point severity scale, where 4 is the most severe rating (intolerable), and who produced at least 50 mg of sweat in each underarm at rest over five minutes. The label also says patients should be evaluated for causes of secondary hyperhidrosis, such as hyperthyroidism, so treatment does not cover up an underlying disease.
See a physician first if the sweating is widespread, affects one side more than the other or began after a new medicine or illness. The 2019 review says secondary hyperhidrosis tends to be generalized and asymmetric and comes from diseases or medications. Tell the office about aminoglycoside antibiotics and muscle relaxants, which the label says may strengthen the toxin's effect or add to weakness.
608
Google reviews across both officesWho treats you
Arshia Payman, MD
Board-certified physician with 13+ years in aesthetic medicine. Dr. Payman is the only provider at Derm Clinic MD, and she personally treats every patient. Every plan starts with a consultation, so it is made around your face and your goals.
- Medical schoolGeorge Washington University, Washington, D.C., where she also earned her undergraduate degree summa cum laude and was accepted to the early selection medical program in her sophomore year
- Hospital trainingFour hospitals in the Washington, D.C. area, including the National Institutes of Health and George Washington University Hospital
- ResidencyCompleted in 2008 at George Washington University
- Academic medicineOutpatient internal medicine at Emory University in Atlanta, as an instructor in clinical medicine who taught medical students
Georgia medical license 61513 (NPI registry).
Read Dr. Payman's full bioYour visit
What happens during a Botox for sweating visit?
Every treatment starts with an in-person consultation. Expect questions about when the sweating began, which areas it affects, what you have tried and what medicines you take, so you and Dr. Payman can decide whether Botox fits. If it does, she plans and performs the injections, and explains the specifics.
- ConsultationYour sweating history, topical products you have tried and conditions such as thyroid problems.
- Consent, photos and a plan, including how the sweating area will be outlined; the label describes outlining it before injecting.
- TreatmentSmall injections into the skin of each underarm.
- AftercareFollow your written aftercare instructions.
- Repeat visitsThe label says to repeat when the effect of the last injection fades.
Cleveland Clinic says the injections are usually done within 30 minutes. See our guide to a first med spa consultation for what to bring, and the aftercare page for general guidance.
Cost
How much does Botox for sweating cost?
The office quotes your cost at the consultation, after the plan is made. Underarm treatment is a medical use of Botox, so ask whether your health plan covers any of it and whether Gold member pricing applies. Cleveland Clinic notes the treatment can be expensive when insurance does not cover it.
See pricing and membership for what the site lists, and our guide to Botox cost in Atlanta for how Botox pricing works in general. When you are ready, book a consultation at either office.
Gold membership
$99 a month, saved toward Botox, Jeuveau or dermal fillers
- Jeuveau at $10 per unit, Botox at $11 per unit
- A vitamin B12 injection each month
- A chemical peel in your birthday month
- 10% off other services and skincare
Six-month minimum, then month to month. A $99 fee applies if you cancel before six months.
Compare
How does Botox compare with antiperspirants and other sweating treatments?
Antiperspirants come first for primary focal sweating, and Botox is approved for adults whose severe underarm sweating topical agents have not managed. A 2019 review places iontophoresis mainly with palm and sole sweating, oral medicines with resistant or widespread cases, and surgery later, after conservative treatment fails.
| Option | Where it fits, per a 2019 review |
|---|---|
| Antiperspirants | First-line for primary focal sweating |
| Iontophoresis | Main remedy for palms and soles |
| Botulinum toxin injections | An effective treatment option for focal sweating |
| Oral medicines | Reserved for resistant or generalized sweating |
| Surgery | Considered when conservative treatments fail; sympathectomy is a last resort and can cause compensatory sweating |
More on how they compare
The table summarizes the therapeutic options review. In a 2025 meta-analysis of 12 randomized trials with 904 people, Botox reduced underarm sweat more than placebo and was comparable to other treatments, with fewer side effects. Ask Dr. Payman which option fits where and how much you sweat.
Safety
What are the risks and side effects of Botox for sweating?
In the label's double-blind studies, injection site pain and bleeding, sweating in other areas, infection, sore throat, flu-like symptoms, headache, fever, neck or back pain, itching and anxiety were among the most frequent side effects, reported in 3 to 10% of adults. Rarely, botulinum toxin can spread beyond the injection area; trouble swallowing, speaking or breathing needs emergency care.
Full safety details
The Botox label carries a boxed warning: effects can spread from the injection site, symptoms have been reported hours to weeks after injection, and swallowing and breathing difficulties can be life threatening. The label also states that no definitive serious reports of distant spread of toxin effect have been associated with Botox for severe primary axillary hyperhidrosis at the recommended dose. The AAD's botulinum toxin FAQ says side effects tend to be mild and temporary, and it lists swelling, redness, soreness and bruising among them, with botulism-like symptoms such as trouble breathing, swallowing or speaking as very rare. The label also reports serious and immediate allergic reactions, including anaphylaxis.
Patient reviews
In patients’ words
“I was a bit apprehensive about Botox and spending the money on myself, but Dr. Payman and her team makes the whole process stress-less and pleasant.”
“I only trust this clinic with my Botox and fillers.”
“She really takes her time to fully understand the results I am looking for…”
Excerpts are quoted word for word from public Google reviews of Derm Clinic MD. Individual results vary.
Questions
Questions patients ask about Botox for sweating
Short answers here. Your own plan, product and cost are set with Dr. Payman at your consultation.
Ask at a consultationDoes Botox for sweating hurt?
Injections go into the skin, and the label lists injection site pain among the most common side effects. Cleveland Clinic quotes a surgeon saying underarm injections are usually more uncomfortable than truly painful, like a quick pinch or sting, and that palms and soles hurt more. Ask the office what it does for comfort.
Can Botox treat sweaty palms, feet or face?
Those uses are off-label. The Botox label says safety and effectiveness in areas other than the underarms have not been established, and it warns of hand weakness with palm treatment and eyelid drooping with face treatment. A 2019 review of hyperhidrosis treatment options (Nawrocki and Cha, Journal of the American Academy of Dermatology) names iontophoresis as the main remedy for palms and soles. The Botox for sweating page covers the underarms.
Will I sweat more somewhere else afterward?
Some people notice more sweating in other areas. The label lists sweating outside the underarms among the most frequently reported side effects, in 3 to 10% of adults in the double-blind studies. Tell Dr. Payman if it bothers you, and mention any sweating that is widespread, since that can point to another cause.
Is Botox for sweating okay if I am pregnant or breastfeeding?
Plan to wait. The Botox label says there are no adequate human data on pregnancy, that animal studies showed lower fetal weight and less skeletal ossification, and that there are no data on breast milk or breastfed infants. Tell the office if you may be pregnant or are nursing.
How is Botox for sweating different from Botox for wrinkles?
Both contain onabotulinumtoxinA but have separate labels. The Botox Cosmetic label lists frown lines, crow's feet, forehead lines and platysma bands. The Botox label lists medical uses, including severe underarm sweating, chronic migraine and cervical dystonia. See Botox for wrinkle treatment.
How soon will I notice a difference?
The label's trials measured the response at four weeks, so that is the point its numbers describe. Cleveland Clinic quotes a surgeon saying improvement can start within 24 hours, with full effect after a week or two. Your own timeline may differ, and Dr. Payman can tell you when to check in.
Two offices
Two offices. One physician.
Atlanta, GA 30342
Floor 1 of the Tuxedo Atrium
Cumming
425 Peachtree Parkway, Suite 345Cumming, GA 30041
In The Shoppes at Brannon Crossing
Monday to Friday 8:30 AM to 5 PM; Saturday 8:30 AM to 2:30 PM
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Sources (7)
- BOTOX (onabotulinumtoxinA) prescribing information. Allergan/AbbVie via DailyMed (NLM), label revised 11/2023. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=33d066a9-34ff-4a1a-b38b-d10983df3300
- BOTOX Cosmetic (onabotulinumtoxinA) prescribing information. Allergan/AbbVie via DailyMed (NLM), label revised 10/2024. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=485d9b71-6881-42c5-a620-a4360c7192ab
- The etiology, diagnosis, and management of hyperhidrosis: a comprehensive review: etiology and clinical work-up. J Am Acad Dermatol, 2019. https://pubmed.ncbi.nlm.nih.gov/30710604/
- The etiology, diagnosis, and management of hyperhidrosis: a comprehensive review: therapeutic options. J Am Acad Dermatol, 2019. https://pubmed.ncbi.nlm.nih.gov/30710603/
- Efficacy and Safety of Botulinum Toxin Type A in Primary Axillary Hyperhidrosis: A Meta-analysis and Systematic Review. Aesthetic Plast Surg, 2025. https://pubmed.ncbi.nlm.nih.gov/40500510/
- Botulinum toxin: frequently asked questions. American Academy of Dermatology. https://www.aad.org/public/cosmetic/wrinkles/botulinum-toxin-faqs
- Botox for Sweating: What You Need To Know. Cleveland Clinic Health Essentials, August 11, 2026. https://health.clevelandclinic.org/botox-for-sweating
This page is general education and is not medical advice. It does not replace an in-person consultation. Whether a treatment suits you, and what result is realistic, depends on your health history and an examination. Results vary from person to person.
Derm Clinic MD · Last updated October 2026.