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I've Developed a Tolerance for Botox. Will miraDry Still Work?

Doctor Answers 9

MiraDry can still work in people that don't respond to botox

miraDry and Botox work by two different mechanisms.  The fact that you no longer respond to Botox is not an indicator of whether you will respond to miraDry.  A small percentage of patients do not respond to miraDry, but the percentage is exceedingly small.

If Botox has stopped working to decrease sweating, MiraDry can be used.

If Botox has stopped working to decrease sweating, MiraDry can be used. These procedures attack sweat glands in entirely different ways. And the results of MiraDry should be permanent.

William P. Coleman III, MD
Metairie Dermatologic Surgeon
3.5 out of 5 stars 2 reviews

MiraDry is still effective with Botox tolerance

Yes, miraDry will still work as Botox and miraDry use different mechanisms.  Botox prevents the nerves from firing. miraDry actually removes te sweat and odor glands.

Karyn Grossman, MD
Santa Monica Dermatologic Surgeon
5.0 out of 5 stars 2 reviews

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MiraDry vs. Botox

Hi and thank you for your question! miraDry works to destroy the sweat and odor glands, whereas botox will only work on the sweat glands. Also, botox, as you know, will wear off after about 3 months, whereas miraDry is a permanent option for both sweat and odor reduction, eliminating the need for deodorant and anti-perspirant. There should be no issue with Mirday working, even though you’ve developed a tolerance to botox. In addition, MiraDry just received an indication for hair removal also. 70% reduction of all hair colors. For any miraDry questions please call our office for a complimentary consultation with our Nurse Practitioner, Jennifer Tinelli. Thank you!

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.5 out of 5 stars 95 reviews

MiraDry works even if they have built up a tolerance to Botox

Yes, miraDry works for patients who have developed a tolerance to Botox.  This is because miraDry and Botox have different mechanisms of action.  Botox injections temporarily diminish the firing of the nerves that control sweat gland function while miraDry eliminates sweat glands altogether through a novel microwave technology.  Specifically, miraDry utilizes microwave technology to selectively target and eliminate sweat glands in the armpits by focusing electromagnetic waves at a specific level in the body where sweat glands are located.  Botox typically lasts between 4 and 6 months with the effects wearing off near the end of that time frame.  MiraDry is the only FDA-approved procedure that offers long-lasting results.  Studies demonstrate that miraDry results last up to 2 years and are likely permanent as sweat glands do not regenerate.  

Joshua L. Fox, MD
Long Island Dermatologic Surgeon
5.0 out of 5 stars 12 reviews

Tolerance to Botox and effectiveness of miraDry

Developing a tolerance to Botox has nothing to do with how miraDry works. So, the answer to your question is that in your situation, miraDry is the ideal tratment for underarm hyperhidrosis and will prove in the long run to be a less expensive alternative than repeat Botox injections in the underarms. EliminateSweating

Miradry > Botox

Results of Miradry are achieved through a different mechanism than Botox. THerefore, Miradry will still be effective even if Botox won't! 

Cameron Rokhsar, MD
New York Dermatologic Surgeon
4.5 out of 5 stars 33 reviews

Botox tolerance and MiraDry

I have seen several patients who no longer get the duration of effect for Botox, and they do as well as Botox responders with MiraDry. MiraDry involves the elimination of sweat glands, whereas Botox temporarily suppresses the nerve stimulation of the gland. Since the sweat glands are no longer present, one does not have to worry about a tolerance being developed.

Michael L. Maris, MD
Dallas Dermatologic Surgeon
5.0 out of 5 stars 7 reviews

Choosing the Miradry system or Retrograde Suction Curettage for axillary hyperhidrosis

Treatment of axillary hyperhidrosis has become much more simpler over the years.  Botox works at the nerve-sweat gland synapse, whereas Miradry and Retrograde Suction Curettage works to remove and destroy sweat glands at the base of the skin.


I have been using the Retrograde Suction Curettage treatment for over 5 years and believe that it has the additional benefit of being a definitive one-time procedure in most patients; with longterm success. Surgery90210

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 70 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.