Women Are Getting Scalp Botox, and You Won't Believe Why

by Alina Gonzalez

A mere few days before I got wind of an exciting new trend in the dermatology field, I was having a conversation with a friend about how working out, for me, is a financial decision. See, I just started working out again regularly and really getting back into fitness, like trying different classes and being one of those annoying people who talks about how GREAT their hot yoga class felt (so cleansing and so energizing—I’m a total Hot8 groupie).

But this presents a problem, because I’m ALSO a Drybar devotee, like maybe one of its top 50 customers in the country, just if I’m guestimating. And so when I’ve gotten a blowout—which I need to do for my self-esteem and legitimate viability in the world, because I look like an eccentric and electrocuted scientist without a blowout just because of my hair type—I basically have to decide between throwing my $50 down the drain by sweating in a hard-core fitness class/the gym or not. I always choose the latter, at least for the first few days of a blowout. Because if I go to a class like hot yoga, I will emerge, as everyone does, dripping wet with hair soaked and the imminent need to shower. Doing so would light my Drybar dollars on fire.

So even though I’m super-committed to exercising, when my hair is on fleek, I’m not about to waste the money it took to get it there by effectively taking a sweat shower that necessitates a real shower—because it would mean I’d just have to spend another $50 that much faster because I don’t have the hair type that can just air-dry post-shower and go. I have the hair type that looks like the sad before photo in The Princess Diaries, but more mangled. And thus I was calmly stating to my friend and lamenting the fact that my hair affects my exercise habits. And I knew that if I feel like this—and I’m not some diva; I’m just a real girl with hair problems—there must be so many other women who want to do intense Spin classes but hate how it requires them to be a slave to their hair.

Needless to say, when an email came into my inbox mere days later about how women in New York are now getting scalp Botox to stop sweating to extend blowouts, I about lost it. Do you want to know what my first thought was? It wasn’t how crazy that is, or how bougie of those women to do that. It was “OMG, genius. Where has this been all my life? This is the future. Sign. Me. Up.”

Do I see how completely nuts it might sound at first glance? Kind of, but do I also believe it’s something for which there is a clear need? Clearly. So I spoke to the dermatologist involved, Dr. Dendy Engelman, and asked her every single question that’s probably running through your head right now: like how much does it cost, does it work/how does it work, and how long does it last? Keep scrolling to find out this and so much more about scalp Botox!


Photo: James K. Lowe for Remix

So the first thing I asked Engelman was whether using Botox to stop scalp sweating was being driven by the patient or the medical community and, perhaps unsurprisingly given my story, she said it’s been patient-driven. After patient zero, the demand for it has been completely organic—women telling other women and them showing up at Engelman’s door. The trend is incredibly recent; she said it’s blown up at her practice in just the last six weeks.

“When the first patient I treated came in, she was complaining of how her Spin class addiction was wrecking her hair because of her significant scalp sweating,” Engelman said. “She asked me if there were any topical medications that could be used to mitigate her sweating, and I said that we could try Botox injections because just as it works for axillary hyperhidrosis (excessive sweating of the underarm region), it should work to decrease scalp sweating. It worked, she was thrilled, and the trend started. Since then, a flurry of patients have come to me requesting the scalp treatment, and some others have decided to do it when I offer it as a solution.”

And it’s indeed Spin class addicts, exercise fanatics, and workout-aholics who are the clientele. “I now have more and more patients coming in who are asking for Botox injections all over their scalp in order to decrease sweating so they can prolong their blowouts when attending hot yoga or Spin class,” she said.

Related: Fact or Fiction: 10 Hair Myths Debunked 


Photo: James K. Lowe for Remix

So how exactly does it work? "While most people use Botox for cosmetic reduction of wrinkling, many men and women have been using it for hyperhidrosis, otherwise known as excessive sweating,” explains Engelman. “Typical hyperhidrosis occurs usually on the underarms, palms, and feet. Many men have it injected in their right palm of their hand, to avoid the sweaty handshake. Injections last anywhere between six and 12 months, to minimize sweating in the area in which it is injected. The scalp is an unusual site, but the mechanism of action is the same.”

It is FDA-approved for use as a treatment for hyperhidrosis, and it works by temporarily blocking a neurotransmitter called acetylcholine that controls nerve signals that stimulate sweat glands. “So, it blocks the communication between the nerves and the sweat glands,” explains Engelman.

And just how many Botox shots does it take to cover the whole scalp? About 150 to 200. I know, that sounds like an insane amount, right? If Engelman had texted me that answer, that would have been the point at which I would have sent her back 10 scream-face emoji like, “Uh… Say what?” Luckily, we were speaking, so I expressed my shock in person and said, “That sounds like a terrifying lot—could you put that into context for me based on how many it takes to do the forehead or crow’s feet?” Engelman told me, “It is a lot, but it goes quickly. The whole thing is done in 15 to 20 minutes. For comparison, the crow’s-feet region is three to five injections per side, and forehead is eight to 12 injections.” When she told me it took 15 to 20 minutes, I let go of the 150 to 200 shots thing, because that’s real quick. Drake might even say “0 to 150,” real quick.

Related: An Incredibly Easy Tip for Healthier Hair


Photo: James K. Lowe for Remix

Even better than how relatively quick it is, according to Engelman, is the fact that it’s minimally painful. “I use a very small needle and try to inject into the hair follicle opening so injection pain is minimized. To date, everyone has tolerated the procedure beautifully.” In terms of results, Engelman says, “Everyone is a little different in their response. Some get complete cessation of their sweating, but most report that it significantly decreases the sweating.” Results last for six to 12 months, and it costs $1200 to $1500 per session.

When asked how people are responding to its effect, she said, “People love it. They definitely say they have to get fewer blowouts because their hair is no longer ruined from the sweating. It’s too soon to see if they are coming back for more, because the effects last between six and 12 months, but patients seem thrilled!”

And, in case you were wondering, she says the procedure has no effect on hair growth. “In fact, there are some ongoing studies that are using injected Botox as a treatment for hair loss. This could be a potential benefit to create thicker hair.”

Related: Are You Ruining Your Hair Without Even Knowing It?


Photo: James K. Lowe for Remix

I asked if she knew of any colleagues in the industry who were doing the same thing and getting the same requests, and she said she did not know of others who are currently performing these types of scalp injections, but that people are talking about it. “I was at an industry event over the weekend and told several of my derm and plastic colleagues about it, and they were excited to try it,” she said. “There is no danger in doing this; it is just a new phenomenon we are seeing, and I expect to see it grow in more cosmopolitan cities or wherever a SoulCycle pops up,” said Dr. Engelman. 

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