My keen vigilance against smelling like body odor follows me around like a cartoon fart cloud. I am assured by people around me that the smell is all in my head. There’s a part of me that figures it’s an anxiety similar to being scared everyone is staring when you do something vaguely embarrassing in public — a delicate blend of insecurity and self-involvement that thinks everyone cares as much about you as you do. And yet, it’s a focus I clearly can’t shake, as I keep writing about it and keep researching ways I can deal with it. This time around, it's about getting Botox in my armpits in an attempt to smell better.
It’s not helped by the fact I am an undeniably sweaty person. It doesn’t take much to heat me up to the point where I begin to feel sticky, then slick: a hasty jog to the train station or even just standing in the sun on a temperate day.
I have, for the most part, made my peace with this — the weather and the temperature regulation on public transport are out of my control. And body odor in itself is not a bad thing. If anything, I think that natural scent can be a good thing.
But there are different types of body odor. There’s the general smell of skin, which is largely inoffensive and comes from the eccrine glands that cover the majority of our bodies. If you are not a particularly sweaty person and haven’t experienced any intense exercise or stress, this is likely how the majority of your sweat appears. And then there’s the other kind of sweat, the kind that is funky, pungent, and sour. It’s an odor that reminds me of school locker rooms, unwashed gym clothes, and being unwillingly pressed against office workers when commuting home.
This penetrating scent makes its home in the parts of our body tucked in under hair: most notably the armpits, scalp, and groin. The sweat glands in those areas are known as apocrine glands, which start to function in puberty with stimulation of sex hormones. They constantly secrete a fatty sweat that, when activated by heat, exertion, or stress, is released onto the skin and broken down by local bacteria, turning it into distinctly stinky fatty acids. The more you sweat, the more you will inevitably sweat from these areas of the body, taking your body scent from inoffensive to biting.
This is the sweat that drives my small but significant fear. A little bit of back sweat on a warm day is nothing. But the moment my armpits start joining in, I begin calculating how long it will be until I can change, shower, hide, or all of the above.
I have already taken all the steps necessary to manage the psychological side of this: therapy, medication, mindfulness, sobriety. I also use a heavy duty anti-perspirant (God bless Perspirex) and stick to natural or lightly scented deodorant as I personally find heavy-handed attempts to mask strong smells uncomfortable. These interventions do help, but they don’t solve the problem. I wanted to see if there was a single, if expensive, investment I could make instead.
What is Botox and what does it do?
Botox, the now-familiar brand name for a muscle relaxing botulism toxin, is supposedly this solution. When injected, it blocks the signals sent from the brain telling muscles to contract. This can stymie wrinkles and also, coincidentally, stop the sweat glands from being activated.
Jonny Betteridge, a NHS Medical Doctor and aesthetic clinician who regularly treats clients with excessive sweating, explains to Refinery29 that “because the gland is not getting that impulse to release the sweat, the apocrine sweat glands don't work as effectively.” It can be done on several parts of the body including palms of the hands, under the breast, or between the thighs, but he claims that it’s most commonly used underarm.
While its main target is the overproduction of sweat, reduced body odor can also be a byproduct: there is less sweat to react with skin bacteria and therefore produce those smelly fatty acids. "There is still going to be some odor present, but it does help to reduce that as well," Dr. Betteridge adds.
I'm intrigued, if a little skeptical. And so I head to the Cadogan Clinic in London where Hazim Sadideen, a consultant plastic and reconstructive surgeon based in London, will be performing the non-invasive procedure on me at the Cadogan Clinic. And while it is expensive (costing around $370 a go), it is also relatively quick and painless. As long as you have no conditions that would make the procedure risky like pregnancy, all it takes is 20 minutes with your armpits coated in numbing cream, then a five minute clean up and 10 minute injection process. Thanks to the numbing, my high pain threshold, and the use of a series of fine, small needles in a grid pattern over each armpit, it felt like less than a tiny scratch and was over in minutes.
After being strictly warned not to go to the gym or exert myself for the next 24 hours (you could sweat out the Botox, making it a very expensive workout) I went on my way and waited for the process to kick in. There is a myth that reducing the sweat in some areas will lead to "counter sweat" — a higher production of sweat in other, non-Botoxed areas. But Sadideen says that that’s an unfounded worry. “If you sweat heavily in the armpits, for example, it's not like you're going to start sweating from your head [after Botox in the armpits] — any effect is marginal, and I think the majority of patients are super happy and it's super effective.”
How long before you see a reduction in sweat after Botox injections?
Sadideen explained the procedure starts to show effects within two to four days, and by two weeks later it should be fully in effect. A week later I was on holiday in southern Italy, navigating baking heat, and starting to notice the surreal absence of sweat in a circle under my arms. Even on particularly hot or strenuous days, the skin directly in my armpits made no fuss and I found myself a bit less conscious about the whole body odor thing. I also, thankfully, didn’t notice that I was sweating far more in other places.
However, it did not entirely solve my problem. For one thing, I was still sweating elsewhere (just not more than normal) and clearly the apocrine glands under my arms extended further than the doctor and I realized. Even though the scent was far less pronounced, after a couple of weeks I could tell where the edge of my Botox was because my skin was beginning to develop a smell. If I’d had a strenuous workout or long day, it was like a smelly condensation stain from a cold glass on a table — subtle but obvious to people (aka me) looking out for it.
My experience, however, is to be expected. I was told that following up with the clinic is common practice as there is no way to know ahead of time if the standard dose will really be enough for you. It turns out that I have bigger armpits than expected which could explain why I feel I am a sweatier person and in the wrong hands could make for a new and niche body insecurity. Thankfully, at the Cadogan Clinic they make clear that every body is different and there's no need to stress about any potential anomalies. Instead, you just need to accommodate them with, if needed, more Botox.
Do Botox injections for sweat work for everyone?
According to both Dr. Betteridge and Sadideen, this can be a life-changing treatment. With the reduction of sweat and odor also comes a reduction of insecurity and anxiety, which in turn can boost self-confidence.
I will say that in general I felt far less anxious about myself following the treatment and consider it a success for me in that sense. But without the additional work on the anxiety, I don’t know if the procedure in itself could be considered to have fixed this problem. Dr. Betteridge explains there are lots of different factors that can affect the treatment’s efficacy: who is doing the treatment and their level of experience, the product’s placement, the dose, or potentially sweating out the Botox in the 24 hours after the treatment.
Ultimately if you can afford it and can weather some tiny scratches, it’s worth a go. But it won’t solve everything: if sweat is a source of serious anxiety for you, it is important to tackle the psychological side head on with the help of other professionals, not just aestheticians.