Does insurance cover Botox for hyperhidrosis?

Yes, many insurance companies cover Botox for hyperhidrosis when it is medically necessary. A doctor’s diagnosis and documentation of severe sweating are usually required for approval.

Doctor’s Note: Your Essential Guide to Hyperhidrosis

As dermatologists, we know that excessive sweating, or hyperhidrosis, can be an uncomfortable and frustrating condition. It affects people in different ways, sometimes making everyday tasks difficult or impacting self-confidence. In this guide, we’ll explain what causes hyperhidrosis, its symptoms, and how it can be treated effectively.

What is Hyperhidrosis?

Hyperhidrosis is a medical condition that causes excessive sweating beyond what the body needs to regulate temperature. While sweating is natural and helps cool the body, hyperhidrosis causes an overproduction of sweat even when it’s not necessary, like when you’re at rest or in a cool environment. Hyperhidrosis can affect the hands, feet, underarms, face, and other areas, often creating uncomfortable situations for those affected.

This condition can significantly impact daily activities, emotional well-being, and social interactions. It is important to note how sweating affects your daily life, as this is useful for determining you treatment (see below!).

Contrary to popular belief, hyperhidrosis is not a rare condition; it is estimated to affect about 3% of the population.

Even though hyperhidrosis affects daily life, nearly half of people with it don’t see a doctor, often because they don’t know it can be treated.

Types of Hyperhidrosis

Hyperhidrosis is categorized into two main types: primary and secondary. These two forms of hyperhidrosis are treated differently. The main differences include:

Primary Hyperhidrosis

This type often starts in childhood or as a teenager and affects specific places like the palms, feet, armpits, face, and groin. Doctors aren't sure exactly what causes it, but it might happen because sweat glands become too active, especially when a person feels hot or stressed.

Secondary Hyperhidrosis

This type happens because of another health issue or medication. It can affect bigger areas of the body and usually appears later in life. Reasons for this type can include changes in hormones, problems with the nerves, infections, or certain medicines.

Symptoms of Hyperhidrosis

The main symptom of hyperhidrosis is excessive sweating that doesn’t seem to have a clear reason. This sweating may:

Affect specific areas, like the palms, feet, underarms, or face
Occur even in cool environments or when at rest
Soak through clothing, shoes, or gloves
Make it difficult to hold objects or write due to wet hands

This level of sweating can interfere with daily activities and sometimes affects mental well-being. Many people with hyperhidrosis feel embarrassed or avoid social situations because they worry about visible sweat or odor. Understanding that hyperhidrosis is a medical condition can help reduce the stigma around it.

Diagnosis of Hyperhidrosis

Diagnosing hyperhidrosis usually involves a physical examination and questions about your symptoms. A dermatologist or healthcare provider may ask:

When did your excessive sweating start?
How often do you experience excessive sweating?
Do certain situations make it worse?
Do you have any other medical conditions?

In some cases, additional tests like blood work or imaging may be done to check for underlying conditions that could be causing secondary hyperhidrosis. Dermatologists may also perform tests like the “sweat test,” where a special powder changes color when the skin becomes wet, to confirm the diagnosis.

Daily Tips for Managing Hyperhidrosis

While medical treatments can help reduce sweating, there are also simple lifestyle changes that may help manage symptoms:

Wear Breathable Fabrics: Choose lightweight, moisture-wicking fabrics that allow your skin to breathe.
Avoid Spicy Foods and Caffeine: These can trigger sweating by stimulating the sweat glands.
Stay Cool: Use fans or air conditioning when possible, and drink cold water to keep your body temperature down.
Practice Good Hygiene: Regularly washing and using antiperspirants can help reduce odor and keep skin clean.

Hyperhidrosis Treatment Basics

When it comes to treating hyperhidrosis, we actually only have a few key ingredients for treatment. They fall into two different categories: whether it blocks the TOP of the sweat gland (aluminum chloride) or the BOTTOM of the sweat gland (glycopyrrolate + oxybutynin). Here is a basic breakdown:

Aluminum Chloride

-Reduces sweat production by blocking sweat gland pores.

Glycopyrrolate + Oxybutynin

-Reduce sweat production from the source.

Rx = Prescription, OTC = Over-the-Counter

Over-the-Counter Treatments

Antiperspirants (usually containing aluminum chloride) are the most common over-the-counter treatments for hyperhidrosis. When applied to the skin, the aluminum chloride and sweat combine to form a very tiny superficial plug inside each sweat gland. This blocks sweat from reaching the surface of the skin. This process takes 6-8 hours, so your antiperspirant should be applied before bed on completely dry skin. (It will sting if you apply to damp skin!) You can use this nightly as tolerated. Side effects include skin rash, itching, irritation, and burning. Here's few favorite OTC antiperspirants:

CertainDri

-12% Aluminum Chloride
- Easily available in many stores

Duradry Antiperspirant

-15% aluminum chloride
-Similar to CertainDri, but stronger and with added salicylic acid to increase effectiveness

Carpe Antiperspirant

-Contains aluminum sesquichlorohydrate (NOT aluminum chloride), which is milder and less irritating
- Can order online

NOTE: Antiperspirant is NOT the same thing as deodorant!

Deodorant = reduces odor 👃🏻

Antiperspirant = reduces perspiration AKA sweat 💦

Products can have one or both!

Prescription Topicals for Hyperhidrosis

If over-the-counter products are not strong enough, you can see your physician for prescription treatment. These include:

Drysol

-20% Aluminum Chloride
-Apply nightly at bedtime to dry skin
-Once sweating is reduced (after ~ 3 days), reduce to 1-2x per week
-Side effects: skin rash, itching, irritation, burning

QBrexza Wipes

-2.4% Glycopyrrolate Wipes
-Apply 1 cloth to affected area(s) once daily
-Wash hands after use
-Side effects: skin rash, drowsiness, dry mouth, difficulty urinating, blurred vision

What about the safety of aluminum and its potential health effects? Aluminum is all around us, including in lakes, soil, drinking water, personal care products, and more. For most healthy individuals, exposure to aluminum in day-to-day life, personal care products, and antiperspirants is safe and not a significant cause for concern.

However, as with any health concern, it's essential to discuss specific worries or questions about aluminum exposure with a healthcare professional who can provide personalized advice and guidance.

Prescription Oral Treatment for Hyperhidrosis

Glycopyrrolate and oxybutynin are pills that can help reduce sweating by “drying you out,” so to speak. They work by blocking the signals that tell your sweat glands to produce sweat, which can be helpful for people who sweat a lot in different areas of the body. These medications can make a big difference for some, but they do come with possible side effects. Along with reducing sweat, they can cause dry eyes, dry mouth, blurred vision, constipation, and sometimes make it harder to urinate. In rare cases, they may increase the risk of glaucoma, an eye condition that affects vision.

Because of these possible side effects, patients usually start with a low dose to see how their body responds. Gradually, the dose can be increased until sweating is controlled without too many side effects. This process lets patients find a balance where the medicine helps with sweating but doesn’t cause too much dryness or discomfort. A doctor will guide you through this to make sure it’s safe and effective for you.

In-Office Procedures for Hyperhidrosis

In-office procedures are effective options for managing hyperhidrosis when other treatments don’t work. These procedures target specific areas where sweating is excessive, like the underarms, hands, or feet. One common treatment is Botox injections, which temporarily block the nerves that cause sweating. The effects usually last around three to six months, and the procedure can be repeated as needed. Another option is iontophoresis, a process that uses mild electrical currents passed through water to reduce sweating, especially in the hands and feet. For underarm sweating, miraDry is a newer option that uses microwave energy to destroy sweat glands permanently. These in-office treatments are generally safe, though they may cause some temporary discomfort or side effects. A dermatologist can help you choose the best option based on the areas affected and the severity of your sweating.

Botox

It's not just for The Real Housewives! It’s commonly used to treat excessive sweating in areas like the armpits, palms, and soles. In this procedure, Botox is injected into the areas where you sweat a lot, temporarily blocking the sweat glands. The effects last anywhere from 4 to 12 months, depending on the person. It’s a quick procedure with little discomfort and no downtime. Many patients really like the results, but keep in mind that Botox for sweating isn’t always covered by insurance. Be sure to check with your doctor!

lontophoresis

Iontophoresis is like a mini spa for your hands and feet! It uses water and a gentle electrical current to temporarily block sweat glands. With this device, which you use at home, you place your hands or feet in a shallow tray of water. The tray is connected to a small machine that sends a mild electrical current through the water. Don’t worry—it’s gentle and won’t shock you! To start, you’ll use the device a few times a week. Once you reach the level of dryness you’re happy with, you can switch to a maintenance schedule, usually just once every few weeks. Iontophoresis is often not fully covered by insurance, so be sure to check your plan.

miraDry

miraDry is a non-invasive, FDA-approved treatment that targets the sweat and odor glands in your underarms, providing lasting results. During the procedure, a handheld device delivers targeted electromagnetic energy to the armpits, effectively "zapping" the sweat and odor glands. The best part? Most people only need one treatment to see a big difference. However, keep in mind that miraDry is usually not covered by health insurance.

Hyperhidrosis FAQ

Why do my feet sweat when cold?
Cold sweating in the feet can occur due to overactive sweat glands (hyperhidrosis) or anxiety. It may also result from poor circulation or nervous system responses.

How long does Qbrexza stay in your system?
Qbrexza (glycopyrronium cloth) has a short half-life and typically stays in your system for less than 24 hours after application.

How to prevent back sweat?
To prevent back sweat, wear breathable fabrics, use antiperspirants on your back, stay hydrated, and avoid spicy foods or caffeine. Cooling towels or fans can also help reduce sweating.

How long does glycopyrrolate take to work for sweating?
Glycopyrrolate tablets usually begin working within 1-2 hours of ingestion, but the effects may take a few days to stabilize depending on the dosage and individual response.

Why are my feet sweating but are cold?
Cold, sweaty feet can be caused by hyperhidrosis, stress, or poor circulation. It may also be a symptom of an underlying condition like Raynaud’s disease.

Why are my palms always sweaty?
Sweaty palms are often caused by palmar hyperhidrosis, a condition where overactive sweat glands produce excessive sweat, often triggered by stress, heat, or emotional responses.

Why do my feet sweat so much?
Excessive foot sweating, known as plantar hyperhidrosis, can be due to overactive sweat glands. Tight shoes, synthetic socks, or stress can exacerbate the condition.

How do I get rid of sweaty palms?
To reduce sweaty palms, try using antiperspirants, iontophoresis treatments, or medications like glycopyrrolate. Botox injections and surgery are options for severe cases.

How to stop sweaty feet?
To stop sweaty feet, use antiperspirants, wear moisture-wicking socks, and choose breathable shoes. Foot powders, foot soaks, and medical treatments like Botox or iontophoresis can also help.

How to prevent hyperhidrosis hands?
To prevent sweaty hands, use antiperspirants specifically designed for hands, try iontophoresis therapy, or discuss prescription options like glycopyrrolate with your doctor.

How to stop sweaty hands?
To stop sweaty hands, you can use antiperspirants, carry absorbent wipes, or explore medical treatments like Botox, oral medications, or surgical procedures like ETS (endoscopic thoracic sympathectomy).

Related Topics:

Botox Guide