Note: The pictures of my feet after being injected with Botox along with monthly updates from me are towards the end of this page.
In April 2010, I was traveling around the US west coast and by luck the International Hyperhidrosis Society was having its annual conference in Portland, Oregon on April 10th. They were looking for volunteers who would receive free Botox injections for armpit (axillary) and hand (palmar) sweating from physicians who would be under training at the conference. I contacted the organization to see if they could add me as a volunteer for feet (plantar) sweating treatment and the conference organizer, Lisa, managed to get this approved. The feet require the most injections and take the longest time to treat.
I was not overly concerned about receiving hundreds of injections of a poison (Botox). Millions of Americans use Botox every year for cosmetic treatments such as wrinkle reduction, and most of these people get Botox injected into their facial areas, while I was getting it on my feet, which seemed less dangerous. Still, I would get far more injections in comparison to people who get Botox for cosmetic reasons (or compared to most of the people who get Botox for therapeutic reasons such as to treat blinking eyes, dystonia or migraines), so I was expecting at least some mild side effects such as a headache or feet pain.
I had to stop treating my feet with Idromed iontophoresis around ten days before the conference so that they started sweating profusely again. This way, the physician could see what parts of my feet sweat prior to injecting Botox in them. Several days before attending this conference, my feet started sweating like crazy again since I had ceased iontophoresis therapy.
There were 22 patient volunteers at this conference at the Hotel Monaco in downtown Portland, a significant number of whom not surprisingly lived in the Pacific Northwest region. A few of the volunteers did fly in long distance to get their free Botox. Only three or four of the volunteers were male, including myself. All of the volunteers seemed to be around the age of 30 or under. I was surprised that around half the volunteers only had armpit sweating. Axillary sweating doesn't bother me, but I suppose it is different for many women. Most of the remaining volunteers wanted to get rid of their hand sweating, while only two were getting injected on their feet if I remember correctly. Some had two areas of excessive sweating that they were hoping could be treated with Botox. After getting refreshments and free prescription strength hyperhidrosis products such as Drysol, we were seated in one room and it was quite interesting to talk with some of the people who had a similar problem as myself. I was the only person in attendance who had already had ETS surgery.
I was skeptical that Botox would work on my feet, especially since someone from the Whitley Clinic in the UK and several others have e-mailed me over the years to say that Botox does not work for excessive feet sweating. Prior to coming to Portland, I did contact the offices of Dr. Dee Anna Glaser (who along with Dr. David Pariser was going to train all the physicians at this gathering) to ask if they had success treating feet sweating with Botox, and her staff assured me that it worked. I ended up sitting next to a girl at the conference volunteer gathering who had previously received Botox injections to stop her hand sweating, and she had tremendous success. Her palmar hyperhidrosis completely ceased for one year, and remained minimal for an additional six months. I never knew that Botox could stop hand sweating for more than six months (this length of success is not uncommon for armpit sweating). This also means that Botox can stay in your body for one and a half years. This girl did say that her hands pained during the initial month after she got the injections in them, and even daily tasks such as buttoning a shirt were painful. However, one month of some pain is definitely worth one year of dry hands in my opinion.
I was among the last few to get called from the volunteer gathering in a small room to a larger main hall next door where we received the Botox injections. It seemed like all of the volunteers called in the beginning had axillary sweating. This main hall was full of people, including those volunteers already getting injected, representative(s) from Allergen, physicians training to give the injections, nurses, and several women who seemed to be mixing or just bringing out the Botox from the freezers. My doctor was Dr. Howard Green (a foot doctor from Canada) who I had already contacted prior to coming down to the conference since the International Hyperhidrosis Society had him listed on the conference section of their website as one of the possible doctors to contact. He had me sign some documents and fax them to him prior to this conference. I think Dr. Green had treated people with plantar hyperhidrosis with Botox prior to this conference, so he wasn't a true trainee.
Dr. Green and his assistant told me to lie down face down on a type of table that you often see at doctors' offices. Then they started making green marks underneath my feet (see pictures at bottom of this page), with each mark spaced fairly close to at least several other marks. Dr. Green had a template for this, but the template did not extend on to the sides of my feet, even though he did end up giving me injections on the sides of my feet. The injections were a bit painful at the beginning, especially since they started giving them to me in my sensitive toe area first. Thereafter, it was mostly smooth sailing (I never had pain that was severe enough to make me cry out). I did not get any pain killers injected into my feet. I had physicians come and talk to me all the time I was getting injected, so my mind was a bit distracted from what was happening to my feet too (which also meant that I did not even realize that I got some injections on the upper sides of my feet). The physicians talking to me asked me about what I was feeling and about my hyperhidrosis in general. I was surprised to see at the end that I did have bleeding on my feet despite the lack of any major pain sensation.
The "hyperhidrosis superstars" (as deemed by the International Hyperhidrosis Society) Dr. Dee Anna Glaser and Dr. David Pariser were both in the hall and monitoring things, as was Lisa the organizer of the event. I did get a chance to speak with Dr. Glaser who was fantastic. Unfortunately, she could not inject me even a few times because of federal regulations requiring her only being able to give injections in states where she is registered to do so (Oregon wasn't one of them). Dr. Green said I got around 100 injections in each foot, more than is typical since my feet are larger than the average man's feet. The pictures at the bottom of this page show around 90 marks on the soles of each foot, so I probably got only a little over 10 injections on the sides of each foot (where there are no green marks to make it possible to count the total). At the end of my treatment with Dr. Green, Dr Pariser happened to be watching us and he told me that I received $2,000 worth of Botox. Add to that what I would have had to pay in doctor fees before getting the injections, and I was quite glad I took this opportunity to get free treatment under the eyes of the "hyperhidrosis superstars". Most insurance companies nowadays cover hyperhidrosis treatments (many might classify incessant armpit sweating as a cosmetic problem though), but you would still need to pay a deductible: so getting Botoxed every six months or so can still become expensive.
My results have been incredible so far and Dr. Green and his assistant seem to have done an excellent job. I got instantaneous dryness in my feet after they were injected on April 10, 2010, and this is very unusual. Everyone I talked to and everything I have read seems to suggest that dryness only starts several days after being injected. Perhaps I was lucky in that my feet were sweating profusely right before I was about to get injected (see photos) so that could have impacted the results favorably. I didn't seem to get any side effects except minor pain in my feet while walking during the first couple of days after getting the injections, minor headache on the first night after treatment and a burning sensation under one toe now and again for the first week and a half post-treatment.
I was on vacation for most of the remainder of April 2010 and walked around 50 miles during that time, with absolutely no evident feet pain at all. The feet have been bone dry all the time except when I was walking in places such as Phoenix and Austin in 85 degree weather when parts of the upper sides of my feet (say the area up to one-third of the way up to my ankles in the rear areas of my feet) became slightly wet. Perhaps the number of injections I received on the upper sides of my feet were spread out at greater distances than the numerous of injections I got on my soles. Dr. Green said that most of the sweat glands in the feet are at the bottom sole area, but I seem to have a significant amount on the sides of my feet too. (If Dr. Green has any input on this, I will add it here). This amount of minimal sweating on very hot days on the upper sides of my feet is easily bearable for me, and probably happens to most people who do not even have hyperhidrosis. The unseemly green marker dots on my feet went away a few days after treatment (it helps if you shower daily)!
If these great results last for close to a year, I will seriously consider having Botox injected into my feet every alternate year. I will continue with iontophoresis therapy during the in-between years, since that has also given me great success as long as I use the right type of water it seems. If the results from Botox only last for 3-4 months, I will not risk the regular injection of a toxin into my body.
I would recommend trying out Botox for your hand or feet excessive sweating problems. The International Hyperhidrosis Society has another free volunteer session in June 2010, and you should sign up right away before it gets full. If you can't get in for this free session, I would recommend you going to a physician who has a lot of experience doing this, since a lot of people have complained about no success on the feet and this could be due to being injected by an inexperienced person. Even better would be someone who has been trained at these International Hyperhidrosis Society conferences. Clinics and patients who have reported failure in the past were clearly doing something wrong (e.g., misjudging the number of injections required, misjudging the depth of injections or maybe even using an incorrect Botox formulation).
If you do get good results, but if the results only last for 3-4 months or so, I would suggest trying HIDREX or Idromed iontophoresis instead. I am wary of potential side effects of Botox in the long-term if you get 100s of injections every few months. I am also curious about whether the Botox stays in the area it is injected in, or whether it spreads to other areas of your body. Also, how does it get eliminated from the body (via your urine)? Why did that one girl I mentioned earlier get results lasting over one year? Does that mean none of the toxin moved from her hand area for that long a duration? Since Botox has only become so popular over the past two decades, I think being wary of how frequently you get injected is justifiable. In another decade or two, there will probably be enough evidence to enable us consumers to take more risks.
Update: As of May 20 2010, 40 days after getting injected, I still have completely dry feet almost all the time. Very pleasantly surprised!
Update: As of July 5 2010, I have completely dry feet most of the time, although on several days with 85 degree and above temperatures, my feet did sweat (mostly from the sides, where I did not get a significant quantity of Botox injected).
Update: As of August 8 2010, I am still happy with the results. The only time my feet sweat is when the temperature is above 80 degrees. Even in 90 degree weather, my socks never get anywhere near as wet as they used to. Most likely, this is because the soles of my feet hardly sweat at all. The thing I am most pleased about is that my feet do not sweat at all when the temperature is around 70F to 80F. Next time I get Botox injections, I will try to get them at the end of summer, and hopefully have completely dry feet during all of fall and winter.
Botox for feet sweating: Blood stains and a little bit of sweat are visible in the left photo. The marker dots go away in a few days.
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Patient recommendations of clinics and physicians that offer Botox to treat hyperhidrosis
Locations where you can get Botox injections for hyperhidrosis