Q: Dr. Eppley, I am interested in Botox for hand hyperhydrosis. What is your fee for both hands? How much time is involved? Is a nerve block involved due to pain issues?
A: Botox for excessive sweating of the hands, like everywhere else it is used, is done based on the number of units injected. While the effective dose differs for each individual, the minimum dose for each hand should start at 25 units. (50 units for both hands) If one has had Botox before, they they will have a baseline for the number of units that are most effective. If they have never had it before, then this is a good starting place although maximal effectiveness may require more units. The goal with Botox, like all drugs, is to determine the least dose that is most effective. The cost of Botox is done by the unit. Each practitioner may have slightly different unit pricings so you have to inquire at each specific office for their Botox charges. No doubt the palmar surface of the hand is a very sensitive area to inject. I have managed the injections multiple ways including patients ‘taking it straight’, topical numbing creams and nerve blocks done at the wrist level for the radial, median and ulnar nerves. Bilateral wrist blocks are difficult on a patient when it comes to walking out and expecting to drive home. Treatment time for the Botox injections can vary from 15 to 45 minutes based on what type of anesthesia is done.
Dr. Barry Eppley