What you don’t already know about miraDry

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miraDry is one of the few permanent solutions for underarm sweating, also known as Primary Axillary Hyperhidrosis.  Unlike medications (which have side effects) or Botox injections (which wear off), miraDry leads to permanent reduction in sweat.

miraDry is FDA approved and takes approximately 90 minutes in the office.  At our office, the entire procedure from start-to-finish is performed by the doctor.  During the consultation the doctor will inquire about your medical history and perform a special test called the Starch Iodine Test, to see where you are actually sweating.  Next, the underarm skin is numbed with local anesthesia; this is actually the most important step in the entire treatment since your comfort is our #1 priority.  Finally, you are ready to start the treatment.  Each armpit requires approximately 20-30 minutes treatment time, and you are able to lie on your back throughout.

Starch iodine test (purple=sweat)

Starch iodine test (purple=sweat)

Downtime varies but the average patient reports 3-5 days of mild soreness and swelling.  These are normal and temporary side effects, and are relieved with over-the-counter pain medication and frequent icing of the area.  Results are noticeable within 24-48 hours.  There are no hard restrictions after the treatment however we recommend that you rest for 12-24 hours.  It may be difficult to do upper body exercise for the week after the treatment, so if you’re an avid tennis player, for example, just make sure to schedule your treatment appropriately.

miraDry procedure uses a light handheld device that is placed directly on the skin and moved across the entire area, one pulse at a time

miraDry procedure uses a light handheld device that is placed directly on the skin and moved across the entire area, one pulse at a time

Hyperhidrosis is a diagnosable medical condition, and getting relief is possible with miraDry.  In our experience, both men and women respond well; men in particular are excited about the “cosmetic” aspect of doing something that feels good for themselves, yet still treating a medical condition.  By treating hyperhidrosis and all the stress, anxiety and embarassment that it can cause, miraDry addresses both medical and cosmetic concerns at once.

Runners and other athletes who feel that underarm sweating is a problem are also great candidates.  Dr. Williams, creator of The Runner Lift, has found that runners have distinct dermatologic needs, from medical to cosmetic.  Runners with hyperhidrosis do very well with miraDry and self-report significant improvements in their training and performance.

Finally, long-term data on miraDry shows that it also mildly reduces underarm hair.  Women with blonde or very light brown hairs who previously failed laser hair removal or who want to reduce underarm sweat are particularly great candidates, and the treatment can be tailored for them.

For more information, or to read actual patient reviews and testimonials about miraDry, check out the miraDry page on RealSelf.

Stop Sweating, part II

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In my previous entry, we talked about the condition Primary Focal Hyperhidrosis, or basically, excessive sweating.  The 2 major misconceptions about this condition is that, first, it isn’t a real medical problem (fact: even insurance companies recognize this as a real disease), and, second, most people don’t realize just how many great treatments exist.  Here I discuss the major treatments for Primary Axillary Hyperhidrosis, or excessive underarm sweating:

1) Anti-perspirants: with an active ingredient of aluminum salt, these topical deodorants are considered “first line” up front therapy, meaning you should try them first; there are both over-the-counter and also prescription deodorants and both are affordable

How deodorant works

How deodorant works

2) Oral medication: the main class of medication for treating hyperhidrosis are the “anti-cholinergics” and include glycopyrrolate, oxybutynin, and others.  These drugs block acetylcholine from reaching receptors on the sweat glands, which normally directs the glands to sweat.  Because acetylcholine receptors are located in other areas on the body, there can be a range of side effects.  Therefore, these drugs are generally reserved for young, healthy patients with either generalized sweating in many areas of the body, or patients who already tried other therapies and failed.

Several new topical anti-cholinergics are in development, and thus far show great promise.  Notable among them is DRM04 (Dermira, Inc., Menlo Park, Calif.).

3) Botox: injections into the armpit or hands is performed every 3-6 months, depending on the patient and very well tolerated.  Downside is that the injections may be a bit painful, however this is really very temporary, and the results, while great, eventually wear off.  Prior to injections, we do a Starch Iodine Test, which tells us where the sweating is!

Starch iodine test (purple=sweat)

Starch iodine test (purple=sweat)

4) miraDry: a 90 minute office procedure that uses microwave energy to permanently shut down the sweat glands.  Overall one can expect 65-80% reduction in sweat, and approximately 20% reduction in odor (from experience).  Results are obvious after even 1 single session.  The device is FDA approved in adults age 18 and up, however there is good precedent for treating certain teenagers “off label” in my opinion.  More about miraDry in my next post!

****Other cool stuff: for more information on specialty garments, bedding, and even shoes for people who sweat a lot, see the Fan Faves section on the International Hyperhidrosis Society website