MiraDry At A Glance
- Best Results2 treatments
- Treatment Recovery2-3 days
- Procedure Time120 min
- Skin SpecialistDavin Lim
- Duration of ResultsPermanent
- AnaestheticLocal tumescent
- Back to Work1-2 days
MiraDry is a treatment for excessive underarm sweating, also known as axillary hyperhidrosis. This treatment can reduce sweating by as much as 80% after 2 sessions. A new model has been released for 2022 with a larger applicator size. This means more effective treatments compared to generation one devices from 2015.
FactsFacts on MiraDry for sweating
- MiraDry uses microwave technology to destroy eccrine or sweat glands
- MiraDry can permanently reduce sweating by up to 80%
- It takes 1-2 days to recover from a treatment
- Ideally two sessions are required
- This treatment can only be used to treat excessive underarm sweating
How does MiraDry work?
MiraDry microwaves your sweat glands. There are many ways to destroy sweat glands. Non-selective destruction can be achieved with heat, radiofrequency, lasers, microwave energy as well as physical force such as liposuction.
Once destroyed, sweat glands do not grow back. The remaining sweat glands can, however, increase their output if required.
Which areas can MiraDry treat?
The underarms or axillary hyperhidrosis. This device uses vacuum suction to lift the skin, dermis, & subcutaneous tissue from the underlying tissue before microwave energy is delivered.
With the energy delivery it cannot treat sweaty hands / feet as there is too much collateral damage. If microwave energy hits nerves, as it frequently does in the underarm area, pain & weakness can occur.
Can MiraDry treat sweaty hands and feet?
No. miraDry has been developing new technology for hands & feet over the past few years. As of writing (2022), no device has been released for hands & feet, apart from iontophoresis.
Microwave technology cannot treat the hands & feet due to the presence of important nerves in these areas. MiraDry is developing a device for hands, however it may take 2-3 years before it is released.
How long is the recovery following MiraDry?
24 to 48 hours, depending on the settings. The higher the settings, the more effective the treatment. Conversely high settings are associated with longer recovery, more swelling & a higher incidence of nerve damage. The settings on this device range from Level 2 to Level 5. For level 5, expect swelling for over a week.
When does sweating stop?
Unlike anti-sweat injections, sweating does not turn off completely. You should notice a reduction in sweating within a week of treatment. The second session is usually 6-12 weeks after the first. 10-20% of cases require a third session.
The fundamental difference between MiraDry & anti-sweat injections is the rate of sweat flow. Think of underarm sweating as a tap. MiraDry turns the flow down, whilst Botox injections turn the tap off.
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What are the side effects of MiraDry?
Side effects are seen in less than 3% of cases. Having performed over several hundred cases since Miradry was launched in Australia we understand that side effects are proportional to the treatment level & inversely proportional to the fat buffer in the underarms.
Side effects include-
- Bruising & prolonged swelling of greater than one week
- Pins & needles lasting several weeks, months or permanent
- Weakness of arm (this is very rare)
What are anti-sweating injections?
These treatments are partially covered under Medicare. It takes less than 90 seconds to perform & patients will have a noticeable (often complete) absence of sweating within a week. Anti-sweat injections last between four to eight months. In extreme cases they last 18 to 24 months, whilst at the other end of the spectrum, only 3 months.
- Injections have a long safety record spanning nearly three decades.
- It costs less than a cup of coffee a day to maintain.
- Is side effect free with no downtime.
- I use it as a bridge between temporary treatments & more permanent solutions
- You must try clinical strength antiperspirants before Medicare rebates this treatment. Refer to the relevant section on this website.
What other permanent solutions to cure sweating?
A procedure that has good outcomes is liposuction of eccrine sweat glands. This simple procedure can permanently remove 80% of sweat glands. Most cases only require one treatment. I also use radiofrequency energy to ablate the eccrine glands.
If you have sweaty hands & underarms, ETS surgery may be an option. The risk of ETS is compensatory sweating. Dr Andrew Cartmill, vascular surgeon is my go-to guy for this procedure.
What topical treatments can treat underarm sweating?
Aluminium salts are the most common ingredients in over-the- counter antiperspirants. For the treatment of axillary hyperhidrosis, patients should consider the use of Aluminium Chloride Hexahydrate. Look for concentrations ranging between 10 to 20%.
Application method is critical to achieve maximal benefit, whilst minimizing potential side effects. Aluminium chloride should always be applied to skin that is as dry as practically possible- ideally just after a shower, prior to bedtime. Dry the area off with a hairdryer on the ‘cool setting’. Wash the treated areas in the morning with plain water. If irritation develops, the use of a corticosteroid cream on alternate days can be useful.
Anticholinergic creams such as glycopyrrolate (0.5-3%) can be effective in the management of axillary hyperhidrosis. This solution needs to be made up by a compounding pharmacist. Another option is the use of glycopyrrolate pads. These can be obtained from pharmacies in Canada.
What is CBT and can it help reduce sweating?
Cognitive behavioural therapy (CBT) using biofeedback can be a very useful adjunctive treatment for patients who suffer from anxiety induced axillary hyperhidrosis. CBT is performed by a psychologist, and is often combined with various medical treatments, including Botulinum Toxin Type A.
For anxiety induced sweating, book an appointment with psychologists at the OCD Clinic in Bulimba.
What investigations are required for underarm sweating?
Most cases of axillary hyperhidrosis are idiopathic and primary. If sweating is isolated to areas such as the underarms, hands, or feet no investigations are needed. Investigations should be considered in cases of generalized hyperhidrosis, or if hyperhidrosis occurs in the sleep.
What can be done about tingling secondary to Miradry?
Most nerve pain & tingling will settle within weeks to months. Nerve pain is rare & more frequently encountered when-
- Level 5 (highest settings) are used.
- Absence of proper tumescent technique
- Axillary or underarm areas are lean (low fat)
If you have persistent nerve pain, your GP or neurologist can prescribe you pre-gabapentin (Lyrica) or gabapentin.
Who to see for Miradry treatments?
To see if MiraDry is the best treatment for you, schedule an appointment with myself or my nursing team. We take into consideration factors such as-
- Previous treatments such as Botox
- Your axillary fat content or buffer zone
- Your job (dexterity maybe affected)
- Your expectations
- The contribution of stress to your pattern of sweating
Davin’s Viewpoint on Miradry
Microwave treatment or miraDry can destroy the sweat glands and in doing so also reduces sweating. I was the first practitioner to employ this device in Australia having first seen this treatment in Asia in 2014.
The most important aspect of MiraDry is to pick the correct candidate. The ideal patient has a good buffer of axillary or underarm fat- this offers protection from the electromagnetic waves. Secondly, they should have very little emotional or stress induced sweating (as other sweat glands can compensate). Lastly, they should, have realistic expectations- Botox turns off the tap, often completely. MiraDry reduces the tap flow by 70-80%.
Surgery is less commonly used nowadays and usually reserved for the most extreme cases that do not respond to other treatments. Endoscopic thoracic sympathectomy literally cuts the nerves that supply areas of sweating. This is most useful for treating excessive underarm sweating & sweaty hands.
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