Hyperhidrosis is a troublesome problem that results in awkward social situations for those that are affected. Unfortunately, topical and oral medications, iontophoresis, and surgery have not proven to be efficacious in the majority of patients. Because the eccrine glands are innervated by sympathetic nerves that use acetylcholine as the neurotransmitter, botulinum toxin is effective in temporarily reducing or abolishing sweat production. Although hyperhidrosis is generally not considered a cosmetic problem, many patients will present to the cosmetic dermatologist for treatment of this disorder.