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Botulinum Toxin (Botox) for Hyperhidrosis

Excessive Sweating Treatment: Underarms, Palms and More

Insurance may cover medication · Exact pricing at consultation

Sweating is completely normal physiology. It's your body's built-in cooling system, and it works beautifully, most of the time.

But for some people, the sweat glands simply do not know when to stop. The system stays on when it should be off: during a calm meeting, sitting in an air-conditioned room, before a first date, right before a presentation. The sweating is excessive, unpredictable, and entirely out of proportion to any actual physical demand. It soaks through clothing. It affects handshakes. It becomes something to manage, to hide, to plan around.

This is primary hyperhidrosis: a medical condition driven by overactive sweat gland signalling, not by temperature, anxiety or anything you're doing wrong. It is more common than most people admit, because most people are too embarrassed to bring it up. We'd like to change that.

Botox is one brand of botulinum toxin. In Canada, Botox is the botulinum toxin authorized for excessive underarm sweating (primary axillary hyperhidrosis) in adults. Your physician may also discuss Xeomin, another botulinum toxin, or treatment of the palms, scalp or forehead; those uses are off-label. The product is chosen with you at your consultation, and results typically last about 2 to 6 months.

Medically reviewed by Amber Bocknek, MD, CCFP, ABAARM, FAAMM, MSCP, Medical Director, November 4, 2026

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Gloved provider marking a woman's forehead with a pen during a Botox consultation in Aurora

About This Treatment

How Botulinum Toxin Works for Sweating

Sweat glands switch on when your nervous system sends a chemical signal called acetylcholine. Botulinum toxin blocks that signal where the nerve meets the gland. When we inject it into the affected area, we interrupt the communication line between your nerves and your sweat glands. The glands are still there. The nerves are still there. The signal just doesn't get through for a while. In clinical trials for underarm sweating, most people had a large drop in sweat production, and results typically last about 2 to 6 months. The aim isn't skin that feels abnormally dry; it's taking away the excessive, uncontrollable part that has been running your day.

The Process

How Does It Work?

1

Consultation

Assessment of sweating severity and discussion of treatment areas. Each site is assessed individually. We treat what is most affecting your quality of life.

2

Treatment

Small, superficial injections spaced approximately 1-2 cm apart across the treatment area. For underarms, most patients find it very tolerable. For palms, numbing cream is applied beforehand.

3

Results

Changes usually begin within 2 to 4 days, with the full effect by about 2 weeks. Results typically last about 2 to 6 months, and some people find they last longer with repeated treatments. Little to no downtime: most people return to their day right away. time is usually minimal.

The Process

How Does It Work?

1

Preparation

1

I

Consultation

Assessment of sweating severity and discussion of treatment areas. Each site is assessed individually. We treat what is most affecting your quality of life.

2

I

Treatment

Small, superficial injections spaced approximately 1-2 cm apart across the treatment area. For underarms, most patients find it very tolerable. For palms, numbing cream is applied beforehand.

3

I

Results

Changes usually begin within 2 to 4 days, with the full effect by about 2 weeks. Results typically last about 2 to 6 months, and some people find they last longer with repeated treatments. Little to no downtime: most people return to their day right away. time is usually minimal.

Why Choose This Treatment

Benefits & Treatment Areas

Blocks the nerve signal that switches on sweat glands

Typically lasts about 2 to 6 months

Return to normal activities immediately

May be eligible as a medical expense (ask your accountant)

Changes often begin within days

The medication may be covered by some private drug plans

Botox is approved in Canada for underarm sweating

Treatment Areas

Underarms (axillae): the most common treatment site, and the use Botox is approved for in Canada

Palms (hands): an off-label use

Soles of the feet: an off-label use, considered case by case

Scalp and forehead: an off-label use for significant sweating of the scalp or face

Coverage & Cost

Understanding Your Coverage Options

We want you to have a complete and honest picture of how costs work for this treatment, because the insurance landscape can be genuinely confusing, and you deserve clarity before you book.

The Medication vs. The Treatment Fee

There are two separate costs with botulinum toxin treatment. The first is the medication itself. The second is the treatment fee: the physician's fee for the injections and the follow-up care. These two costs are billed separately, and they are covered (or not covered) separately. Your consultation itself is complimentary.

Private Drug Insurance: What May Be Possible

For underarm hyperhidrosis, the botulinum toxin medication may be eligible for coverage under some private drug insurance plans, but this isn't automatic or guaranteed. Every plan is different, so contact your insurer and ask whether botulinum toxin for hyperhidrosis is a covered benefit, and whether a pre-authorization is required. Coverage for off-label areas, such as the palms or scalp, is less likely.

If Coverage Is Declined

If your plan declines coverage, or you don't have a private drug plan, the medication is paid privately. We'll talk through the product options and their costs with you, including Botox and Xeomin, and you'll know the full cost before any treatment goes ahead.

The Treatment Administration Fee

The physician's fee for the treatment (the injections and the follow-up) is a separate charge from the medication; your consultation is complimentary. In our experience, this fee is rarely covered by private insurance plans, whatever the reason for treatment.

Medical Tax Deductions

Because hyperhidrosis (primary focal excessive sweating) is a medical condition rather than a cosmetic concern, the costs of medically indicated treatment (the medication and the treatment fee) may be eligible as a medical expense on your Canadian tax return. Keep your receipts, and we'll provide the documentation you need. Your accountant can confirm what applies to you.

Integrity in the Insurance Process

If your medication is approved and covered by your drug plan for a specific medical condition, that coverage applies only to treating that condition, as documented, prescribed and administered. Medication covered under a drug plan cannot, under any circumstances, be redirected toward cosmetic use; that would be insurance fraud, with serious legal and professional consequences for everyone involved. Pre-authorization forms are legal documents and must be completed honestly and accurately, so any misrepresentation of a patient's clinical situation, however well-intentioned, is not something we can take part in. Our commitment is to help you get the coverage you legitimately qualify for, through a process that is completely above board.

What Is a Preauthorization Form?

A pre-authorization form is a document your insurance company requires before it will approve coverage for certain medications. It sets out the medical criteria the insurer requires for the medication to be considered medically necessary under your plan. Your physician completes the form based on your clinical history and current situation. If you meet the insurer's criteria, coverage is approved; if not, coverage is declined and the medication is paid privately. If your insurer requires one, let us know and we'll work through it with you.

Got Questions?

Frequently Asked Questions

Is the treatment painful?

For underarms, most people find it very tolerable. For the palms, which is an off-label use, we apply numbing cream beforehand for comfort.

Is this covered by insurance?

For hyperhidrosis, botulinum toxin medication may be eligible for coverage under some private drug insurance plans. Contact your insurer to ask about coverage and preauthorization. The administration fee is rarely covered. See the coverage section above for full details.

How long do results last?

Results typically last about 2 to 6 months. Some people find results last longer with repeated treatments.

Will I stop sweating completely?

No, and that's by design. Botulinum toxin only works where it is placed, such as the underarms, and even there the aim is to take away the excessive, uncontrollable part of the sweating rather than all of it. The rest of your skin keeps sweating normally, so your body's temperature control keeps working.