Crotchtox: How it works and what to expect.
You’ve heard of Botox being used to treat sweaty armpits, chronic migraines, and wrinkles, of course. But the latest injection site for the popular treatment is below the waist. “It’s not unusual to experience some sweating between the leg—especially during exercise and hot weather—but stains on the crotch of your yoga pants or left on the chair you were sitting it can be very embarrassing,” says Karen Whitney, a board-certified physician’s assistant with in Cincinnati, OH. “Women are now getting Botox injections in their groin area in increasing numbers, a type of injection I’ve affectionately started referring to as ‘crotchtox.'”
Botox is FDA-approved for the treatment of axillary hyperhidrosis (AKA excessive underarm sweating), though most dermatologists use it off-label to treat the condition on many different parts of the body. How does it work? Sweating is stimulated by the release of a neurotransmitter known as acetylcholine, which is released from nerves and binds to and activates receptors on the sweat glands, explains Y. Claire Chang, MD, a board-certified cosmetic dermatologist at Union Square Laser Dermatology in New York City. Botulinum toxin (Botox) blocks the release of this neurotransmitter so that the sweating doesn’t start, she says.
While Dr. Chang adds that she personally has not yet used it to treat excessive sweating on the groin, she has used it to treat not only the underarms, but also palms, scalp, and under the breasts. Given that there are many sweat glands in our crotch area, it makes perfect sense that this is the latest area of interest for Botox injections. Whitney points out that most of her patients requesting ‘crotchtox’ are typically very physically active and/or are embarrassed by excessive groin sweat during sex. Some have been treated for hyperhidrosis in other areas previously, but not all, she adds.
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Keep in mind that this is a different mechanism of action than when Botox is used to smooth wrinkles. For cosmetic purposes, it’s injected deeper into the muscles, where it inhibits the communication between the nerves and muscles to minimize muscle movement; for the treatment of hyperhidrosis, it’s injected much more superficially and not deep enough to have an effect on the muscle, notes Whitney.

Here’s what to expect from Crotchtox
Interested? Here’s what to expect from crotchtox: The Botox is injected into the crease that runs from your hip to your crotch, along the diagonal panty line, though it can also be injected lower, near the vagina and rectum, says Whitney. You’ll likely receive several small injections made on each side, in order to spread the effect around this broad area, she adds.
As far as potential side effects go, “Botox is generally safe and effective for the treatment of hyperhidrosis,” says Dr. Chang, with possible side effects including temporary pain and bruising at the injection site. Still, that’s all pending that you see a doctor who knows what they are doing. An inexperienced provider and/or improperly done injections could potentially lead to undesired relaxation of muscles at the vaginal or rectal openings, cautions Whitney, who underscores the importance of finding properly trained clinicians.
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The final crotchtox cost is ultimately dictated by how many units of Botox are used, as well as the provider you see and where they’re located. For reference, Whitney says it usually ranges from 25 to 50 units at a cost of $200 to $600. Not cheap, but keep in mind that this might be something you only need to do once a year, particularly if sweat stains on your workout pants are only an issue for you in warmer weather. The effects of Botox for hyperhidrosis usually last about six months, but can range anywhere from four to 14 months, says Dr. Chang.
The bottom (no pun intended) line: If you’re seriously stressed about crotch sweat, it may be worth looking into Botox injections as a treatment option. Just make sure to do your research and find an experienced provider to ensure the best—and safest—possible outcome.
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