GLASS LAB · Medical Aesthetics Evidence Index 303 cells · 19,226 papers · 5,969 top-tier evidence

Hyperhidrosis · Osmidrosis / body odor

Botulinum toxin a evidence for Osmidrosis / body odor

B 57.5 / 100 Supported 7 RCT/meta · 1 clinical/observational · 3 case · 19 total
Good evidence · positive conclusion

There is a relatively good level of clinical evidence, and a majority of papers support its effectiveness.

Grade combines the quantity and quality of the research, while direction is a separate signal showing how the papers assess effectiveness.

Includes meta-analysis/SR Median year 2018 Last 5 years 37% Positive results 79% Negative results 1 Korea/Asia 2

Known in Korea as

톡신보톡스제오민디스포트코어톡스주름 보톡스다한증 보톡스디자인 보톡스사각턱 보톡스얼굴전체 톡신

Procedure and brand names vary, but the evidence above applies to the same procedure mechanism.

Key papers

tier1 Botulinum Toxin Type A in the Treatment of Primary Axillary Hyperhidrosis:A Phase 3, Multicenter, Randomized, Double-Blind, Placebo-Controlled Study of Efficacy and Safety in Chinese Patients. Aesthetic surgery journal · 2026 · PMID 41553927

Abstract summary (English) BACKGROUND: The efficacy and safety of botulinum toxin type A (BoNTA) treatment for primary axillary hyperhidrosis (PAH) have not been explored in the Chinese population. OBJECTIVES: The objective was to evaluate efficacy and safety of 1 intradermal BoNTA injection in Chinese PAH cases. METHODS: This was a Phase 3, multicenter, randomized, double-blind, placebo-controlled study.

Journal Article, Randomized Controlled Trial, Multicenter Study, Clinical Trial, Phase III

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tier1 Tolerability and efficacy of botulinum toxin injection in the treatment of bromhidrosis: a systematic review and meta-analysis of clinical trials. Acta dermatovenerologica Alpina, Pannonica, et Adriatica · 2024 · PMID 39707893

Abstract summary (English) This review evaluates the risks and benefits of botulinum toxin (BTX) therapy for treating bromhidrosis. A search was conducted across six databases, including clinical trials comparing BTX therapy with BTX-free controls. The analyzed outcomes included pooled adverse events (AEs), treatment success, ≥ 50% overall improvement, and recurrence rates.

Journal Article, Meta-Analysis, Systematic Review

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tier1 Treatment of axillary bromhidrosis in adolescents by combining electrocauterization with ultrasound-guided botulinum toxin type A injection. Journal of plastic, reconstructive & aesthetic surgery : JPRAS · 2021 · PMID 34238698

Abstract summary (English) The aim of this study is to investigate the efficacy of treatment-combined electrocauterization after removal of apocrine sweat glands with ultrasound-guided (BOTOX) injection for adolescents with axillary bromhidrosis. From January 2015 to January 2018, 90 adolescents with axillary bromhidrosis were recruited and randomly divided into three groups (group A, B, and C). Patients in group A underwent...

Journal Article, Randomized Controlled Trial

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tier1 Efficacy and Safety of Botulinum Toxin A in Axillary Bromhidrosis and Associated Histological Changes in Sweat Glands: A Prospective Randomized Double-Blind Side-by-Side Comparison Clinical Study. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] · 2019 · PMID 30829777

Abstract summary (English) BACKGROUND: The efficacy of botulinum toxin A (BTX-A) therapy in axillary hyperhidrosis has been documented; however, there are a few studies reporting the efficacy of BTX-A in treating axillary bromhidrosis. The histological changes occurring in sweat glands after BTX-A treatment are also unknown. OBJECTIVE: The authors report on the efficacy and safety of BTX-A in the treatment of axillary bromhidrosis and on the...

Comparative Study, Journal Article, Randomized Controlled Trial

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tier1 Local injection of botulinum toxin A: an alternative therapy for axillary osmidrosis. The Journal of dermatology · 2014 · PMID 24386960

Abstract summary (English) The objective of this study was to investigate the efficacy of local injection of botulinum toxin A for treating axillary osmidrosis. One hundred and fifty patients with axillary osmidrosis were randomly divided to receive botulinum toxin A injection treatment (50 U of botulinum toxin A was injected intracutaneously into 6-20 different sites within each axilla, n = 74) or surgical excision of the apocrine glands (n...

Journal Article, Randomized Controlled Trial

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tier1 Making scents: improvement of olfactory profile after botulinum toxin-A treatment in healthy individuals. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] · 2007 · PMID 17241419

Abstract summary (English) BACKGROUND: The axilla is particularly associated with body odor and putative pheromone production in humans. Although botulinum toxin type A (BT-A) is injected increasingly into the axillary skin to stop excessive sweating, its potential to control body odor is largely unexplored. OBJECTIVE: The objective was to measure the impact of BT-A on human axillary odor in an objective and reproducible fashion.

Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't

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tier1 Amelioration of body odor after intracutaneous axillary injection of botulinum toxin A. Archives of dermatology · 2003 · PMID 12533165

Abstract summary (English) BACKGROUND: Body odor is a ubiquitous phenomenon. It is commonly attributed to sweating and noted explicitly in the axillary area. Botulinum toxin A has recently been shown to be effective for axillary hyperhidrosis.

Clinical Trial, Journal Article, Randomized Controlled Trial

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tier2 [Comparison study on the efficacy of three methods for the treatment of osmidrosis]. Zhonghua zheng xing wai ke za zhi = Zhonghua zhengxing waike zazhi = Chinese journal of plastic surgery · 2010 · PMID 21174789

Abstract summary (English) OBJECTIVE: To compare the efficacy of decollement, combined tumescent liposuction and curettage, Botox injection in the treatment of osmidrosis. METHODS: From September 2006 to April 2009, 350 patients with osmidrosis were treated by decollement method in 180 cases, curettage in 120 cases,and Botox injection in 50 cases. The therapeutic effect and complications were retrospectively analyzed.

Comparative Study, Journal Article

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tier0_review Contemporary Algorithm for Treating Bromhidrosis: A Review of Treatment Available. Aesthetic plastic surgery · 2025 · PMID 39747420

Abstract summary (English) Bromhidrosis significantly impacts individuals' social, professional, and emotional well-being. Traditional treatments such as en bloc excision and alcohol injections are now less favored due to associated complications and suboptimal outcomes. Current evidence identifies botulinum toxin A (BTX-A) as the first-line treatment for mild to moderate cases (Grade 0-2), attributed to its high efficacy, excellent safety...

Journal Article, Review

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tier0_review Using Neuromodulators for Salivary, Eccrine, and Apocrine Gland Disorders. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] · 2024 · PMID 39196843

Abstract summary (English) BACKGROUND: Sialorrhea, hyperhidrosis, bromhidrosis, and chromhidrosis are common glandular disorders that substantially impact patients' health and quality of life. Botulinum toxin can safely and temporarily decrease gland secretions by targeting the parasympathetic cholinergic neurons, resulting in diminished saliva and sweat production. OBJECTIVE: The objective of this article is to describe the applications of...

Journal Article, Review

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