- Best ResultsVariable
- Treatment Recovery0-7 days
- Procedure Time5 to 30 mins
- Skin SpecialistDermatologist
- Duration of ResultsCan be permanent
- Back to Work0-6 days
Radiofrequency For Excessive Sweating
Radiofrequency or RF is a method of thermal destruction of eccrine or sweat glands. Other non-selective methods include microwave technology, called miraDry, as well as long pulse lasers. Once destroyed, sweat glands do not grow back. RF can reduce sweating by up to 85%.
FactsFacts on Radiofrequency Ablation for Excessive Sweating
- RF is a treatment for excessive underarm sweating
- RF non-selectively destroys sweat glands in the hypodermis
- Energy in the form of heat is delivered to the area with a probe or insulated needles
- This procedure is done with local numbing agents, coolers & mild sedation
- Long term results can be expected in the majority of cases
- Sweat reduction is permanent
How does RF or radiofrequency treat sweating?
RF works by superheating the dermis & hypodermis. Temperatures of 67 to 69 degrees are delivered over half a second. The heat non-selectively destroys the eccrine or sweat glands. Once destroyed, sweat glands do not grow back.
What forms of excessive sweating can be treated with RF or radiofrequency?
As of 2022, the only safe area is the axilla or armpit. Hence only patients who suffer from excessive underarm sweating can be treated with RF. This is because the energy is delivered in the hypodermal layer of skin. The same applies to all other energy devices including Miradry & lasers (as well as liposuction of sweat glands).
RF energy is non-specific, hence the underlying nerves in the hands & feet can be accidentally ablated giving neuropraxia & neuralgia.
What types of RF - radiofrequency are there for sweating?
I use one of two types. Firstly simple RF microneedling(RFM), preferably with insulated needles. This includes the Genius RF (updated Infini RF) & the Morpheus 8. RFM delivers a pulse of energy to a predetermined level. This energy pulse non-selectively ablates the eccrine sweat glands through heating. Each pulse of RF delivers approximately 30-60 insulated needles beneath the skin.
Probe RF is known as Facetite. This minimally invasive treatment provides RF in a horizontal plane, as compared to RFM which is delivered vertically. This form of RF is often combined with liposuction of the eccrine glands. A skin cooling device is used on the external surface of the skin as it protects the upper dermal & epidermal layers.
How effective is RF for sweating?
Studies have shown it markedly reduces sweating in up to 85% of patients. As a reference, miraDry’s success rate is around 70-80%. Botox is still the highest at 96%
I do believe that providing controlled heating gives a better outcome compared to straight forward eccrine gland liposuction.
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What are the side effects of this procedure?
RFM is inherently safer as the needles are kept at a constant depth. RF sub dermally with a probe (Facetite) has more risks including-
- Skin burns
- Irregular depressions (fat loss)
- Neuropraxia (nerve damage)
- Neuralgia (nerve pain)
The pros & cons will be discussed with you during the consultation. Side effects are higher in patients with a very lean body mass index, namely less than 10% body fat. The primary reasoning is that there is less buffer zone, namely subcutaneous fat. In this group of patients, I do not encourage energy treatments such as RF, lasers or Miradry. The risk of nerve damage is too high for my standard of practice.
Is the treatment painful?
No. I use local numbing injections, a cooler for the surface of the skin, & in some case, mild sedation. The procedure is not painful.
Post operatively, you may have some dull pain (amendable with Panadol). Swelling decreases over 3-7 days.
How many sessions will you require?
It depends on the severity of sweating, the thickness of your axillary vault & your expectations. As a guide, RF with liposuction – one session only. RFM may require 2-3 sessions for optimal results.
It is important to note, the endpoint of any sweat treatment/s is a reduction of sweating. Successful treatments will reduce sweating by 70 to 85%. The results are permanent.
What are other non-invasive treatments to reduce sweating?
See the relevant sections on this website to understand the treatment ladder for sweating. As a guide-
Step one: clinical strength antiperspirants include aluminium chloride hexahydrate. This can be effective in mild to moderate underarm sweating. Look for a formulation that ranges between 10-20+ %.
Step two: Botox injections. This simple treatment is covered under Medicare if step one does not work. Injections take 30 seconds to perform per side, & work well in over 96% of patients. Anti-sweat injections typically last between 4-8 months.
Step three: include tablets, cognitive behavioural therapy, glycopyrrolate wipes & consideration of more invasive treatments including ETS, liposuction, lasers, RF, microwave therapy & others.
How does RF compare to miraDry for excessive sweating?
The results following RF treatment for sweating is comparable to many other non-injectable treatments. This includes Miradry, with quoted success rates of 70 to 80%. I have used Miradry in the past (for over 5 years). I do think that RF offers comparable results with less side effects & downtime compared to microwave ablation of sweat glands.
Is this procedure covered under Medicare?
No. There are only three procedures covered under Medicare for sweating. They include-
- Anti-sweat injections. Medicare covers 3 sessions per year. They involve tiny injections of neuromodulators that block sweating. This treatment typically lasts 4-8 months. Excellent results are seen in over 96% of patients.
- ETS or transection of the sympathetic nerves. This treatment is good for sweaty hands & underarms. It has a high success rate & is performed by a vascular surgeon. Rebound sweating is seen in up to 50+ % of cases.
- Excision of underarm sweat glands or axillary vault. This is historical, whoever performs this procedure in today’s treatment algorithm may not understand the treatment ladder. This procedure was conducted in the 1970s- 80s
Davin’s Viewpoint: RF for excessive sweating
This procedure is a novel treatment for excessive underarm sweating. There are many variations of delivering RF energy including stand-alone RFM using vertical insulated needles. Devices include Infini RF, Genius RFM, Morpheus 8 & many others such as Secret, Intracel, Intensif, Scarlet, Vivace. This procedure as stated is novel. The results depend on the settings. For lower powered non-insulated devices, super-pulsing can give good results. For over-powered insulated devices, results are better, albeit higher risks.
For permanent sweat reduction, I often combine liposuction of the eccrine glands with RFM in the one setting. This can give good results in over 85% of patients. It compares favourably with miraDry, with less side effects & downtime.
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