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"Susoga"—a condition where you're so self-conscious about sweat and odor around your underwear that it makes you feel restless even in your daily life.

 

Because this is such a sensitive topic, you may have found it difficult to talk to others about it and have been struggling with it on your own.

 

First, I’d like to point out that dark underarms are caused by a combination of your body type and environmental factors, and that there are several care options available.

 

Among these methods, Botox is known as a way to temporarily reduce sweat production. Since body odor tends to become stronger when sweat and sebum mix with the skin’s natural bacteria, some people may find that reducing sweat itself helps alleviate the odor.

 

On the other hand, the degree to which this is noticed varies depending on a person’s physical constitution and the composition of the odor (apocrine sweat, eccrine sweat, sebum, etc.).

 

Even during consultations in Tokyo or Ginza, I get the impression that patients are more satisfied when they choose Botox with a clear understanding of what it can and cannot do.

 

In this article, we’ll break down the effects of Botox on the lower eyelids, as well as the pain, downtime, duration of results, and risks, in simple terms.

 

[Doctor’s Point]

We’ve organized this guide to help you choose a doctor when seeking consultation in Ginza, Tokyo, and to alleviate—even if only slightly—any anxiety or uncertainty you may have before making a decision.

How Susoga Works and the Effects You Can Expect from Botox

"Susoga" refers to a condition in which the odor tends to intensify due to the mixture of sweat from apocrine sweat glands—which are concentrated around the genital area (mons pubis, outer labia, groin, and perineum)—along with sebum and sweat from eccrine sweat glands, which is then broken down by the skin's resident bacteria.

 

The basic mechanism of Botox (a botulinum toxin preparation) is to temporarily weaken the signals (acetylcholine) sent from nerves to sweat glands, thereby reducing "moisture" primarily by suppressing the secretion of eccrine sweat.

 

As a result, the source of the odor is reduced, and some people find that the odor becomes less noticeable to them.

 

However, for people whose body odor is primarily caused by apocrine sweat and sebum, the effects of Botox alone may be milder.

 

One question we often get is, “Does Botox actually work on the odor from the groin area itself?”

 

While it doesn’t directly eliminate odors, it’s fair to say that as the humidity and components caused by sweat decrease, bacterial activity subsides, creating an environment where odors are less likely to develop.

 

Please note that the way the effects manifest and the intensity of the experience vary from person to person, and not everyone will experience the same changes.

Things to Know Before Consulting About Botox in Ginza, Tokyo

• At the start of the consultation, can the doctor work with you to “first identify the causes of the odor”? A doctor who carefully analyzes factors such as odor, sweat, sebum, hair, infection, and dermatitis will also make a thorough assessment of whether Botox is appropriate.

• A thorough understanding of the anatomy of the genital area is essential. Since nerves and blood vessels are located nearby, careful consideration must be given to the injection site and depth. For peace of mind, choose a physician—whether an obstetrician-gynecologist or a female urologist—who is knowledgeable about the pelvic floor, pelvic floor muscles, and the sensation and blood flow in the vulva.

• They offer recommendations that include non-injection treatments (such as medical-grade antiperspirants, laser hair removal, and skincare). The more comprehensive your approach, the less likely you are to notice the odor.

• Even when “Before & After” examples are presented, do they address individual differences? Appearance and subjective symptoms vary widely, so it’s important to view personal accounts as merely examples.

Treatment Process, Pain, and Downtime (Basically the Same in Ginza, Tokyo)

Generally, during the consultation, the doctor confirms the suitability and treatment area; after obtaining the patient’s consent, they mark the area, cool it, and administer anesthesia (topical anesthesia or a small amount of local anesthesia), and then inject Botox in small doses using a very fine needle.

 

The procedure typically takes about 20 to 40 minutes. The pain is often described as a “prickling sensation,” but sensitivity varies from person to person.

 

Downtime typically involves small needle marks, mild swelling, redness, and bruising, which usually subside within 2 to 7 days.

 

Clinics in Ginza, Tokyo generally provide similar guidance, such as limiting bathing to a shower on the day of treatment and avoiding strenuous exercise or alcohol consumption to minimize physical strain on the day of the procedure.

Estimated Duration and Frequency of Clinic Visits

The effects of Botox typically last about 3 to 6 months.

 

In the Susoga region, the effects of movement and friction are easily felt; while some people experience it for a relatively short time, others feel it gradually for six months or more.

 

While many people consider scheduling maintenance two or three times a year, we recommend adjusting the schedule to fit your daily routine (such as during the summer when you sweat more).

 

While we can’t guarantee that repeated use will “definitely” make the effects stronger, many people find that as they learn to identify odor triggers and adopt practical lifestyle tips, their daily lives become more comfortable.

For those who want to carefully consider the risks and side effects

• Side effects may include minor bruising, redness, swelling, mild pain, and discomfort. In rare cases, some people may experience temporary discomfort due to weakness in the surrounding muscles, but this usually subsides over time.

• To prevent infection, it is important to ensure a clean environment during the procedure and to follow proper aftercare instructions (such as avoiding strenuous exercise and long baths on the day of the procedure).

• As a general rule, please refrain from receiving this treatment while pregnant or breastfeeding. If you have any pre-existing medical conditions or are taking any medications, please be sure to inform us in advance.

• If you have an infection, such as dermatitis or a Candida infection, treatment should be your top priority. It’s safer to get your skin in good condition first rather than rushing into Botox treatment.

Alternatives to Botox and How to Choose Between Them

• Medical-grade antiperspirants (aluminum chloride, etc.): A method that’s easy to try at first. If you’re prone to experiencing a tingling sensation, adjust the concentration or frequency.

• Laser Hair Removal: It reduces the conditions that cause hair, sebum, and sweat to mix, making it easier to reduce the source of odor. Some people use it in combination with Botox.

• Daily Living Care: Wear breathable underwear; wash or wipe off sweat as soon as possible; avoid overusing antibacterial soap to protect your skin’s natural barrier, and so on.

• Surgical Approach: Treatments for apocrine glands carry a high risk of injury, changes in sensation, and scarring, so careful consideration is necessary when treating sensitive areas. Even in Tokyo and Ginza, it is common practice to start by considering less invasive methods.

Rather than focusing on which option is “best,” it’s important that we work together to find the choice that best addresses your main concerns (sweat volume, odor intensity, and skin issues) and fits your lifestyle.

Choosing a Doctor: Why We Recommend Obstetricians/Gynecologists and Female Urologists

Maintaining a balance of nerves, blood vessels, lymphatic vessels, and muscles is crucial in the intimate area. Even when administering Botox to the perineum, care must be taken to preserve sensation in the vulva.

 

We recommend an obstetrician-gynecologist who can tailor treatment to your specific symptoms, or a female urologist with specialized training in female urology.

 

While there are many options in Tokyo and Ginza, please keep the following points in mind.

• Sometimes, doctors who were once in the obstetrics and gynecology department but have since switched to cosmetic surgery—and are no longer actively practicing in the field of obstetrics and gynecology—may present themselves as if they were still obstetricians and gynecologists. Be sure to verify whether they are up to date on the latest medical knowledge and maintain a system for treating pelvic floor conditions.

• Even among urologists, it is not uncommon for some to have limited experience in female urology. Even if a doctor appears to specialize in women’s health, their clinical experience with pelvic organ prolapse and pelvic floor muscles may be limited, so be sure to confirm whether they have specialized training in female urology.

• It’s reassuring to choose a doctor who can evaluate your vagina, vulva, and pelvic floor during an examination and who will propose treatment options—such as Botox, skincare, hair removal, and surgery when necessary—while providing an unbiased comparison of each.

How to Interpret "Before & After" Images and Manage Expectations

While "Before & After" photos can be helpful, it's difficult to convey the perception of odor through photographs alone.

 

Please keep in mind that the personal experiences and “Before & After” examples presented here may vary depending on lifestyle, skin type, sweat type, and the season.

 

Carefully discussing “how this applies to you” during your consultation is a meaningful first step toward gaining a sense of understanding.

Costs, Insurance, and Privacy Considerations (Market Rates in the Ginza Area of Tokyo)

Botox treatments for sagging skin are considered elective procedures and are not covered by insurance. The cost varies depending on the treatment area, the amount of Botox used, and the aftercare plan.

 

Since price ranges vary widely in Tokyo and Ginza, be sure to confirm the estimate and details (follow-up visit fees, whether touch-ups are included, anesthesia, and aftercare) during your consultation.

 

It’s also important to check whether the facility offers privacy features, such as private rooms and a staff composed primarily of women.

The Benefits of Choosing Botox in Tokyo or Ginza, and Who Should Proceed with Caution

• Suitable for: People who sweat heavily and tend to experience a stronger odor when it mixes with sweat. People whose symptoms tend to worsen with the seasons or during exercise. People who are prone to skin irritation from antiperspirants.

• People who want to proceed cautiously: Women who are pregnant or breastfeeding; those currently suffering from an infectious disease or dermatitis; and those with other prominent symptoms such as pelvic organ prolapse or urinary incontinence (an evaluation of the underlying cause is required first).

There are many clinics in Tokyo and Ginza that offer a wide range of Botox treatments, and the wide variety of options is a major advantage.

 

On the other hand, since there is so much information available that it can be easy to feel overwhelmed, it’s best to base your choice on the doctor’s expertise, the clarity of their explanations, and the quality of their aftercare.

Summary

While Botox injections for Susoga may reduce moisture caused by sweating and potentially lessen the perception of odor, the actual results vary from person to person depending on individual constitution and the underlying causes of the odor.

 

That’s why it’s important not to rely solely on Botox, but to combine it with medical-grade antiperspirants, laser hair removal, and skincare that protects the skin’s barrier, and to tailor these treatments to fit your lifestyle.

Advice

Treatments must be performed with respect for the anatomy and sensitivity of the intimate area.

 

When considering treatment in Ginza, Tokyo, be sure to have a frank discussion with an obstetrician-gynecologist or a female urologist about what Botox can and cannot do.

 

Why not start by taking some time to see if this is right for you? The quickest way to feel at ease is to find a doctor who won’t pressure you into anything, but will listen carefully to your concerns and explain your options—including Botox—in an unbiased manner.

 

If you're interested, feel free to reach out to us.

 

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