HomeProcedures多汗症ボトックス

多汗症ボトックス: Downtime

Very mild Category: ワキガ・多汗症治療 Last updated: 2026-07-13
Botox for excessive sweating is an injectable treatment in which small amounts of a botulinum toxin–derived product are injected into areas where sweating is a concern (underarms, palms, soles of the feet, forehead, and so on). It is said to reduce sweating by temporarily calming the nerve signals that tell the sweat glands to work. Because no scalpel is involved, downtime is generally considered relatively mild: even if needle marks, mild redness, or bruising appear, they are said to settle within a few days to about a week for most people. The effect does not appear immediately after the injection — it builds gradually over roughly 2–3 days to 2 weeks, and is generally said to last around 4–6 months, though both vary from person to person. Note that if you are diagnosed with severe primary axillary hyperhidrosis (underarms), the treatment may be covered by insurance in Japan, whereas for areas such as the palms, soles, and forehead it may fall outside the domestically approved indications (off-label use), and some facilities may use products that are not approved in Japan. Please confirm the product used and the approved indications with your doctor in advance. This page summarizes the typical course from treatment day to the final result, along with points to keep in mind in daily life. Actual recovery varies from person to person, so please make your final decision after being examined by a physician.
DowntimeA few hours to 1…
PainVery mild
MakeupUsually fine as …
Work / social lifeOften possible f…

Downtime at a glance

Needle marks and mild redness typically last a few hours to a few days; if bruising appears, expect around 1 week. The injection sites are usually hidden by clothing, so time off work is generally said to be unnecessary in most cases.

Typical downtime is A few hours to 1 week (if bruising appears, it usually fades almost completely within about 1–2 weeks), and most people feel comfortable being seen in public after Often possible from the same day (for palm injections, those who do a lot of fine handwork may feel more comfortable allowing a few extra days). How much swelling or bruising appears varies from person to person, depending on constitution and the extent of treatment.

Recovery timeline: treatment day to final result

Treatment day

Fine needle marks, redness, and mosquito bite–like bumps may appear at the injection sites. The bumps usually settle within a few hours. On the day itself, avoid rubbing the area firmly, and it is safer to skip strenuous exercise, alcohol, long baths, and saunas. For underarm treatment, you will generally be advised not to use antiperspirants or deodorants on the day of the procedure. Showering is often allowed from the same day, but follow your clinic's instructions.

Next day

For many people, redness and bumps become less noticeable by this point. If bruising is going to appear, small bruises may show up around this time, but since the underarms and palms are hidden by clothing, the impact on daily life is usually small. Desk work and going out are often possible as usual.

Day 3

Needle marks and redness have mostly settled for many people by this stage. Those who respond early are said to start noticing reduced sweating around now. If the palms were injected, tenderness when pressing may remain, but it tends to ease gradually.

1 week later

By this point, the visible downtime is barely noticeable for most people. Any bruising begins to fade. More people start to notice a change in how much they sweat, though how the effect appears varies from person to person.

2 weeks later

The effect is generally said to be mostly complete by this time. It is a good point to check how much your sweating has decreased and whether there is any left–right difference, and to consult your doctor about anything that concerns you. For palm treatment, it is also reassuring to check around now whether your grip strength has changed.

1 month later

Downtime has fully settled and the effect is stabilizing. This is when many people notice everyday differences, such as fewer sweat stains and changes in odor (the degree of effect varies from person to person).

4–6 months later (duration of effect and considering re-treatment)

The effect is not permanent and is said to fade gradually over about 4–6 months (this varies by area and individual). When you feel the sweating returning, it is time to discuss re-injection with your doctor. Many people are said to have the treatment every year before summer.

Bars show approximate swelling levels (individual results vary).

Common symptoms

SymptomLikelihoodWhen it appearsHow long it lastsNotes
Needle marks and small red dotsHighImmediately after treatmentA few hours to a few daysBecause many small injections are placed in a grid pattern, fine needle marks and redness may appear temporarily, but they are said to settle within a few days in most cases.
Swelling and raised bumps (welts)MediumImmediately after treatmentA few hours to 1 dayRight after the injections, mosquito bite–like bumps may appear due to the product and the needle stimulation, but they usually become unnoticeable within a short time.
BruisingMediumSame day to the next day1–2 weeksBruising can occur when a needle nicks a small blood vessel. The underarms and palms are hidden by clothing, so bruises tend not to stand out in daily life.
Dull pain, stinging, and tendernessMediumImmediately after treatment to a few daysA few daysYou may notice pain when pressing on the injection sites or mild stinging for a while. The palms and soles are easily irritated by walking and everyday tasks, so symptoms there can last somewhat longer.
Weaker grip or difficulty with fine hand movements (with palm injections)LowA few days to 2 weeks afterA few weeks to a few months (until the effect wears off)If the product affects the small muscles of the hand, grip strength may temporarily weaken or pinching movements may become harder. This is said to fade as the effect wears off in most cases, but if your work involves a lot of handwork, discuss it with your doctor beforehand.
Feeling that sweating elsewhere is more noticeableLowOnce the effect appearsUntil the effect wears offBecause the treated area sweats less, some people feel that sweating in other areas stands out more by comparison. The degree varies from person to person; consult your doctor if it concerns you.

When can I do what? (Daily-life restrictions)

ActivityTypically OK fromKey point
MakeupUsually fine as normal from the same dayFor injections in areas other than the face, such as the underarms or palms, there is said to be little impact. If the forehead was treated (for scalp/forehead sweating), avoid rubbing the injection points firmly on the day of treatment.
ShowerOften allowed from the same dayIt is safer to rinse the injection sites gently rather than scrubbing them.
Bathing (soaking in the tub)From the next dayA long soak on the day of treatment boosts circulation and can make bruising and redness more likely, so it is safer to avoid it.
AlcoholFrom the next dayDrinking on the day of treatment may make bruising more likely, so it is safer to avoid it.
ExerciseFrom the next day (light exercise) / strenuous exercise from around day 2–3Strenuous exercise right after treatment raises circulation and is said to sometimes lead to swelling and bruising. It is safer to hold off on heavily sweat-inducing exercise for a few days.
Sauna and hot-stone spaFrom around day 2–3High heat promotes circulation and can make redness and bruising more noticeable, so it is safer to wait a few days.
Antiperspirants and deodorants (for underarm treatment)From the next day to a few days later, as a guideWhile needle marks remain, the skin can be easily irritated by these products, so it is safest to resume once the redness has settled. Follow your clinic's instructions.
Shaving the underarmsFrom a few days later, as a guideA razor blade passing over needle marks can irritate them, so it is safer to wait until the redness has settled. Some clinics advise finishing hair removal by the day before treatment.
Medical laser hair removal (on the injected area)From about 1–2 weeks laterLaser treatment while needle marks or redness remain can be irritating, so it is safest to wait until the skin has settled. Discuss the order and timing with your doctor.
Massaging or firmly pressing the injection sitesFrom about 1 week laterFirm rubbing has been noted as potentially spreading the product beyond the intended area, so it is safer to avoid it for a few days to a week.
Can you hide it? Concealment difficulty ○○○○○ / The underarms, palms, and soles are naturally hidden by clothing and everyday movements, so little effort is usually needed to conceal them. Even if bruising appears, sleeved clothing covers it naturally. If the forehead was treated (for scalp/forehead sweating), covering the needle marks with bangs works well. How easily the area can be hidden varies from person to person.

Pain and anesthesia

The typical pain level is Very mild. Underarm treatment is often performed without anesthesia, or with a topical numbing cream and/or cooling. For the palms and soles, a nerve block or nitrous oxide (laughing gas) may be used in addition to topical anesthesia. Options differ by facility, so please check the details with your doctor. Because the injections are shallow and use a fine needle, underarm treatment is generally described as a mild pricking sensation. The palms and soles, on the other hand, are more sensitive areas where pain tends to be felt more strongly, so some form of anesthesia is often considered. Sensitivity varies from person to person — if you are worried about pain, discuss it with your doctor in advance.

Tips for a smoother recovery

Risks and side effects (the honest version)

If a symptom lingers or gets worse, do not try to judge it yourself — contact the medical institution where you had the procedure.

Spacing and combining with other procedures

If you have a specific occasion when you want sweating under control — summer, a wedding, a presentation — allow for the time it takes the effect to fully appear (about 2 weeks) and have the treatment 2–4 weeks before the day. Re-injection in the same area is generally considered once the effect starts to fade, around 4–6 months later. Because repeating treatment at short intervals has been noted as potentially leading to antibodies that reduce the effect, leave at least 3 months between sessions and follow your doctor's guidance on spacing and frequency.

Combined procedureTimingWait timeReason
Botox Injection for Expression Lines (Forehead, Frown Lines, Crow's Feet, etc.)Same day OKSometimes combined on the same dayBecause both are injectable treatments using the same family of product, they can generally be done on the same day. However, there are guideline limits on the total dose per session, so your doctor will decide how to allocate the areas and amounts.
Medical Laser Hair Removal (Underarms)Wait requiredAbout 1–2 weeks, as a guideLaser treatment right after the injections can irritate the needle marks and redness, and doing both on the same day makes the recovery harder to interpret. Some clinics prefer finishing the hair removal first and injecting afterward — plan it together with your doctor.
Microwave Treatment (for Underarm Odor and Excessive Sweating)Wait requiredAround 4–6 months later, once the Botox effect has fadedWhile the Botox effect remains, it is said to be difficult to judge how well the microwave treatment is working. It is advisable to decide the treatment plan with your doctor, including which to have first or whether to switch.
Surgery for Underarm Odor (Gland Excision, etc.)Wait requiredGenerally assessed after the effect has worn off (a matter of months)While the injection's effect remains, it is hard to assess the true severity of symptoms, which can affect the decision on whether surgery is needed. If you are considering surgery, it is safest to be examined by a doctor once the effect has faded.

Who it may suit / who should be cautious

May suit you

  • Those bothered by underarm sweat and sweat stains, to the point of choosing clothing colors around them
  • Those whose sweaty palms make them self-conscious about paperwork, using a phone, or shaking hands
  • Those who want to address sweating concerns without surgery and with relatively short downtime
  • Those who want to keep sweating under control just for summer or a specific event
  • Those who feel over-the-counter antiperspirants are not enough

Consider carefully

  • Those who are pregnant, breastfeeding, or planning to become pregnant soon
  • Those with neuromuscular disorders such as myasthenia gravis
  • Those with a history of allergy to the injected ingredients
  • Those with an infection or inflammation at the injection site
  • Those whose main goal is fundamentally improving underarm odor (osmidrosis) — other treatments may be more suitable
  • Those with medical conditions or medications for whom a doctor judges the treatment unsuitable

Frequently asked questions

Does Botox for sweating hurt?
For the underarms, the pain is generally described as a mild pricking from a fine needle, and some clinics use a topical numbing cream or cooling to ease it. The palms and soles, however, are more sensitive and tend to hurt more, so some facilities combine a nerve block or nitrous oxide (laughing gas). Sensitivity varies from person to person — if you are worried about pain, discuss it with your doctor in advance.
When does the effect start, and how long does it last?
Rather than working immediately, the treatment is said to reduce sweating gradually over about 2–3 days to 2 weeks. The effect is generally said to last around 4–6 months, and once it fades, re-injection is the usual way to maintain it. Both onset and duration vary considerably from person to person, so ask about the likely outlook at your consultation.
Does it help with underarm odor too?
Some people are said to notice less sweat-related odor as sweating decreases, but because the treatment does not act directly on the apocrine glands considered the main cause of underarm odor (osmidrosis), its effect on odor is considered limited. If improving odor is your top priority, talk to your doctor about other options as well, such as microwave treatment or surgery.
Is it covered by insurance?
For the underarms, treatment may be covered by insurance in Japan if you are diagnosed with severe primary axillary hyperhidrosis. There are diagnostic criteria, and the medical institutions that can offer covered treatment are limited, so check in advance. Treatment of the palms, soles, forehead, and other areas is generally elective (self-paid), and depending on the area it may fall outside the domestically approved indications (off-label use).
How many days off work do I need?
Downtime is relatively mild, and in most cases no time off is said to be needed. The injection sites are hidden by clothing, so working and going out from the same day is common. However, if your palms were injected and your job involves a lot of fine handwork, it is reassuring to allow a few days' leeway in case your grip strength changes. Recovery varies from person to person.
When should I have the treatment to be ready for summer?
Because the effect is said to take about 2 weeks to fully appear, many people have the treatment 2–4 weeks before sweating season begins — for example, in spring or early summer, ahead of the height of summer. With the effect generally lasting around 4–6 months, planning the timing makes it easier to cover the summer. We recommend deciding the schedule together with your doctor.
Will I start sweating more somewhere else?
Some people are said to feel that, with less sweat from the treated area, sweating elsewhere becomes more noticeable by comparison. The total amount of sweat produced by the body is not thought to increase significantly, but how it feels varies from person to person. Consult your doctor if it concerns you.
Can I have it around the same time as underarm laser hair removal?
Having both on the same area on the same day is generally avoided, both because it irritates the needle marks and because it makes the recovery harder to interpret. It is safest to leave about 1–2 weeks between the injection and the laser session, or to finish the hair removal first and then have the injection — discuss the order and spacing with your doctor.
This article was written and is kept up to date by our editorial team, based on general knowledge in cosmetic surgery and aesthetic dermatology, the package inserts of the products and medical devices involved, and publicly available information from government agencies and medical societies. It is not an advertisement for any specific medical institution. Editorial policy
This article is for general informational purposes only and is not an advertisement for any specific medical institution. All figures are typical guidelines; results and recovery vary from person to person. Please see a physician before making any final decision. The information on this site is provided for general informational purposes only and is not a substitute for diagnosis, treatment, or medical advice. Final decisions about a procedure's suitability, risks, combinations, and intervals must always be made after being examined by a physician.