In addition to reducing the cosmetic appearance of wrinkles, muscle relaxant injections are also used to treat a multitude of medical disorders, including strabismus (cross eyes), blepharospasm (uncontrolled blinking), muscle stiffness, muscle spasms, migraine headaches, and movement disorders such as cervical dystonia, torticollis. Muscle relaxant injections use a toxin called onobotulinumtoxinA, which temporarily prevents a muscle from moving. This toxin is produced by the microbe that causes botulism, a type of food poisoning. When used correctly by a trained medical professional,  muscle relaxant injections are completely safe.

Muscle relaxant injections are commonly used as a cosmetic treatment to smooth facial wrinkles by paralyzing muscles, but the TGA has also approved muscle relaxant injections as an effective treatment for excessive sweating in the axilla, the space below the shoulder through which vessels and nerves enter and leave the upper arm; commonly known as the armpit.

This muscle relaxant treatment works by blocking the nerves that cause excessive sweating under the arms. This form of treatment can last anywhere from 4 months to a year, with most patients seeing results for about nine months.

For individuals that have tried antiperspirants with little or no success, muscle relaxant injections just might be the answer for you! Muscle relaxant injections may also be used “off-label” to reduce sweating in other areas, such as the hands, feet, and face.

What is hyperhidrosis?

Hyperhidrosis is the medical term for excessive sweating caused by overactive sweat glands.

There are two types of hyperhidrosis: primary focal hyperhidrosis and secondary generalized hyperhidrosis. 

Primary focal hyperhidrosis

Primary focal hyperhidrosis (PFH) is excessive sweating not caused by another medical condition or a side effect of medication. 

A person with PFH typically experiences symmetrical sweating on specific areas of the body. For example, they may experience excessive sweating on both hands or both feet. 

Secondary generalized hyperhidrosis

Secondary generalized hyperhidrosis (SGH) is when a medical condition or side effect of medication causes excessive sweating. People with SGH tend to sweat across large sections of the body. They may also experience night sweats (sweating while sleeping.)  A person with SGH symptoms should consult a doctor to determine the cause.

When to see a doctor about excessive sweating

In some cases, it may be possible to control sweating with a strong antiperspirant. A person can ask a pharmacist for advice on the best products to use.

Because many over-the-counter treatments may not be effective, individuals with the following conditions are encouraged to seek medical advice:  

• Symptoms of SGH
• Excessive sweating around the groin or feet 
• Excessive sweating that causes avoidance of regular activities and daily life interactions

Pros and Cons of muscle relaxant injections for excessive sweating 

Pros

• Less invasive than surgical treatment
• Minimal pain when used in the armpit area
• Safe
• Effective 
• TGA-approved
• Decrease in sweat production after two weeks 

Cons 

• May be more costly than other treatments
• Painful when injected in hands and feet 
• Follow-up injections are needed every 7 to 16 months
• Only FDA-approved to treat armpits
• Side effects are possible  

The United States Food and Drug Administration (FDA) has approved muscle relaxant injections as a treatment for excessive sweating in the armpit area. The treatment works by blocking a chemical in the body that activates the sweat glands. According to a recent study, underarm muscle relaxant injections can reduce underarm sweating by 82–87%, and the effects can last 4–12 months.

People who receive underarm muscle relaxant injections tend to see results just 2–4 days after treatment, with full effects noticeable within the first two weeks.

While muscle relaxant injections are not a permanent solution for excessive underarm sweating, a single treatment can last up to a year, making this a highly effective solution for excessive sweating that interferes with one’s daily life. To date, the FDA has approved muscle relaxant injections for underarm use only, however, a doctor may prescribe the treatment for excessive sweating on other parts of the body, including hands and feet.

How do muscle relaxant injections work?

Muscle relaxant injections alter the function of certain neurotransmitters. These are chemicals in the body that instruct the body to react in a certain way. Muscle relaxant injections block the neurotransmitter that tells the sweat glands to activate to control sweating in the injection area. 

Procedure

A dermatologist, or a medical professional certified in the use of muscle relaxant injection toxins, can perform the injections in their office. Experienced medical professionals can inject both underarms in 10 minutes or less.

For the procedure, a medical professional injects very small amounts of muscle relaxant injections beneath the skin. They usually inject it in a grid-like pattern, with injection sites approximately 1–2 centimeters apart. 

Though generally painless, before injecting the skin, a doctor may use a numbing agent such as ice or a local anesthetic to help ease any discomfort.

Preparation and aftercare

Below are some tips to follow before and after treatment.

Before the procedure

DO  tell your doctor about any medical conditions you have and the medications you currently take to reduce the risk of side effects and complications.

DO NOT shave your underarms for 3–4 days prior to the treatment. 

After the treatment

DO go home immediately after the procedure. 

DO NOT exercise on the day of the procedure.

DO NOT take hot baths or showers for the rest of the day. 

Most healthcare providers recommend a follow-up appointment 1–2 weeks after the procedure. This is to touch up any missed areas and check for side effects.

Side effects

Muscle relaxant injections are generally safe. Serious side effects are rare but possible. They include:

• Severe muscle weakness or asymmetry
• Anaphylaxis, a severe allergic reaction
• Toxicity
• Difficulty breathing, swallowing or speaking
• Skin rash or hives
• Muscle weakness
• Vision problems
• Dizziness
• Loss of bladder control

A person who has any of the side effects above after muscle relaxant injections should seek immediate medical attention.

Less severe side effects may include:

• dry mouth
• headache
• fatigue
• Minor discomfort or pain in the  injection sites

Other muscle relaxant injections uses

Other potential uses for muscle relaxant injections include:

• Muscle disorders: muscle relaxant injections can help relax clenched muscles and control overactive muscle movements, such as muscle twitches.
• Chronic migraine: muscle relaxant injections can help prevent chronic migraines in some people.
• Facial wrinkles: Drmatologists commonly provide muscle relaxant injections to reduce the appearance of lines and wrinkles on the face.

[H2] Take Away

Muscle relaxant injections are an effective way to control excessive sweating. The FDA has approved this treatment for underarm use only, but a doctor may prescribe the injections to control excessive sweating in other areas of the body.

Though muscle relaxant injections are relatively costly compared with other treatments for excessive sweating, because each treatment lasts 4–12 months, the cost can be comparable.  Some health insurance providers can cover the expense when other treatments are not successful. Please check with your healthcare insurance provider. 

Because excessive sweating can sometimes indicate an underlying medical condition or a side effect from a medication, a person should see a doctor if they have concerns about excessive sweating.

At Specialist Skin Solutions, we offer muscle relaxant injections to treat excessive sweating in the armpits, hands, and feet,  as well as other areas of the body.  You will experience a highly professional and advanced level of care when you visit our clinic. Our team of highly skilled professionals is here to answer your questions.

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