1. Perform Iodine Starch Test. (See below for a step-by-step description.)
  2. Reconstitute BOTOX® product
  3. Prepare treatment area
  4. Map area for injection
  5. Inject BOTOX® product
See below for an illustrated guide to performing the iodine starch test and injection procedure for BOTOX® in patients with severe axillary hyperhidrosis that is inadequately managed with topical agents. This information can also be accessed in a video or slide format.
Iodine Starch Test Information Patients should shave underarms and abstain from use of over-the-counter deodorants or antiperspirants for 24 hours prior to the test. Patient should be resting comfortably without exercise, hot drinks, etc for approximately 30 minutes prior to the test. Dry the underarm area and then immediately paint it with iodine solution. Allow the area to dry, then lightly sprinkle the area with starch powder. Gently blow off any excess starch powder. The hyperhidrotic area will develop a deep blue-black color over approximately 10 minutes.
1 First dry affected axilla. Then immediately paint axilla with iodine solution, making sure to cover excess area around axilla. Allow iodine to dry.
2 Brush area with starch powder and wait 10 minutes. (A blue-black mark identifies affected area.)
3 Circle affected area with a surgical marker, then clean area inside circle with alcohol.
4 Use a surgical pen and standard ruler to mark injection points 1.5 to 2 cm apart and staggered.
5 Count injection points and allocate recommended dosage of BOTOX® solution per injection, based on 50 Units per axilla.
6 Inject to a depth of approximately 2 mm and at a 45° angle to skin surface with bevel side up. Be sure not to inject directly on ink mark to avoid a permanent tattoo effect. After injection, clean treated area with alcohol.
  1. BOTOX® Prescribing Information.