Living with primary hyperhidrosis is not easy — I know this first-hand. You test product after product, and you’re always asking yourself: what’s going to actually work for me?
Over the years, I’ve looked into everything from antiperspirant lotions and wipes (I wrote about them here) to bigger-ticket treatments. Right now, in 2025, the four options that come up most often in real conversations with doctors and patients are:
- Brella — the new sweat patch that takes just 3 minutes per armpit.
- Botox — injections that block sweat signals, often lasting half a year or more.
- Sofdra — a prescription gel you apply at home every night.
- Iontophoresis — a device that runs a gentle current through water (best for hands and feet).
I wanted to put them all head-to-head for you — in plain language. Below you’ll see what I’ve learned, where each one shines, and the downsides that don’t always get talked about.
Quick Takeaways Before We Dive In
- Brella: Quick, needle-free, but only works on underarms and lasts about 2–4 months.
- Botox: The heavyweight champ in terms of duration (6–7 months), but it’s pricey and involves needles.
- Sofdra: A daily gel you can use at home (ages 9+), but the side effects can be tricky if you’re sensitive to anticholinergics.
- Iontophoresis: Best for sweaty hands and feet, low long-term cost, but takes discipline to keep up with weekly sessions.
My Head-to-Head Comparisons
Brella vs Botox
Brella vs Sofdra
Brella vs Iontophoresis
Botox vs Sofdra
Botox vs Iontophoresis
Sofdra vs Iontophoresis
Pros & Cons in Plain English
- Brella — Love how quick it is, but I wish it lasted longer.
- Botox — It works, but not everyone wants to deal with needles or the price tag.
- Sofdra — Perfect if you want control at home, but the side effects can be a deal-breaker.
- Iontophoresis — Still my top pick for sweaty hands/feet; it just takes commitment.
Side Effects I Noticed in My Research
- Brella — just mild tingling or redness where the patch was applied.
- Botox — the usual injection pain, sometimes bruising, and in the palms, you can get temporary weakness.
- Sofdra — dry mouth, blurred vision, urinary issues if you’re sensitive.
- Iontophoresis — skin dryness, tingling, or irritation; not for people with pacemakers or during pregnancy.
So… Which One Should You Choose?
- If you want needle-free and quick → Brella or Sofdra.
- If you want the longest gap between treatments → Botox.
- If you’re focused on hands/feet and affordability → Iontophoresis.
- If you’re buying for a teenager (9+) → Sofdra is currently the only FDA-approved option.
👉 My tip: Download and use my decision checklist. Bring it to your doctor so you can tick off what really matters to you.
FAQs
How much does Brella cost?
Most clinics list it around $300–$500 per session, but remember it only lasts a few months.
How long does Botox last?
On average 6–7 months for underarms, sometimes longer.
Can kids use Sofdra?
Yes — it’s FDA-approved for kids 9 years and up.
Does iontophoresis help armpits too?
It can, with pads, but it’s mostly recommended for hands and feet.
Which one is cheapest long-term?
Definitely Iontophoresis. One-time device cost (~$450–500) and then just water/electricity.
Which one kicks in fastest?
Brella wins here — usually within 3–5 days. Botox takes longer, Sofdra and iontophoresis need consistency.
Final Word
I’ve tried a lot over the years, and honestly? There isn’t one magic cure. It comes down to:
- Where you sweat most
- How much time you’re willing to invest
- Whether you can tolerate needles or medications
The best move is to know your options, weigh them against your lifestyle, and bring these notes (or my checklist) to your next appointment.
And if you want to dive deeper into each one:
