Q: What are the pros and cons of MiraDry?

Pros Clinical research in the journal Dermatologic Surgery shows that MiraDry is effective in over 90% of patients, and around 80% require only one treatment to reduce wetness by about 80%. Results from the MiraDry system can be seen and felt within a couple of days, sometimes even immediately. This non-invasive treatment is considered permanent since sweat glands do not regenerate, and it’s a longer-term alternative to repeated Botox sessions for hyperhidrosis . It can also impede hair growth, which means less need for shaving. Cons Though the underarm area is cooled to mitigate the heat felt during the treatment, side effects—including swelling, redness, and post-treatment discomfort—are common. In the Dermatologic Surgery clinical study, two patients (of 31) declined a second session due to unwanted side effects. MiraDry treatment isn’t cheap, but compared to Botox injections, which run about $875 according to RealSelf members and last around seven months, it’s still very cost-effective for lasting reduction of underarm sweat.

Question 1

What is MiraDry?

Accepted Answer

MiraDry is a nonsurgical, FDA-cleared treatment that uses electromagnetic energy to painlessly reduce the number of underarm sweat and odor glands, eliminating excessive sweating and odor (aka axillary hyperhidrosis).

Sweating is a natural and essential body function, however those with axillary hyperhidrosis tend to be self conscious of their condition (which can often cause stained clothing and even infections).

Your underarms contain only 2% of your body’s sweat glands, so you’ll still perspire elsewhere on your body after a MiraDry treatment, which doesn’t affect your body’s ability to cool itself. But MiraDry can be a lasting solution for reducing underarm sweat.

Question 2

What are the pros and cons of MiraDry?

Accepted Answer

Pros

Clinical research in the journal Dermatologic Surgery shows that MiraDry is effective in over 90% of patients, and around 80% require only one treatment to reduce wetness by about 80%.
Results from the MiraDry system can be seen and felt within a couple of days, sometimes even immediately.
This non-invasive treatment is considered permanent since sweat glands do not regenerate, and it’s a longer-term alternative to repeated Botox sessions for hyperhidrosis.
It can also impede hair growth, which means less need for shaving.

Cons

Though the underarm area is cooled to mitigate the heat felt during the treatment, side effects—including swelling, redness, and post-treatment discomfort—are common. In the Dermatologic Surgery clinical study, two patients (of 31) declined a second session due to unwanted side effects.
MiraDry treatment isn’t cheap, but compared to Botox injections, which run about $875 according to RealSelf members and last around seven months, it’s still very cost-effective for lasting reduction of underarm sweat.

Question 3

How much does MiraDry cost?

Accepted Answer

The price you pay will depend on your provider's level of experience and practice location, as well as how many treatments you have. Some practices offer discounts for multiple treatments.

See our complete guide to MiraDry costs

Question 4

MiraDry before and after pictures

Accepted Answer

The MiraDry photos in our gallery have been shared by the provider who performed the procedure, with the patient's consent.

Question 5

Who’s a good candidate for MiraDry?

Accepted Answer

You’re a good candidate for MiraDry if excessive underarm sweating impacts your daily life—the activities you do (or avoid), the clothes you wear. A 2016 study estimates that hyperhidrosis affects at least 4.8% of the U.S. population, with many of those afflicted never seeing a doctor for a formal diagnosis. You don’t need a hyperhidrosis diagnosis to get MiraDry treatment.

It can be particularly helpful for people who experience stress and anxiety from their excessive sweating, including avoiding social activities and missing work opportunities because they’re worried about sweating in front of other people. A John Hopkins University clinical trial is currently exploring the psychological and social benefits of sweat reduction with MiraDry.

The treatment can also be a good option if you’re sensitive to antiperspirant or deodorant and want to control wetness and odor in a different way.

Related: The Most Effective Treatments for Excessive Sweating

Question 6

How does MiraDry work?

Accepted Answer

The treatment works by selectively heating and destroying underarm sweat glands, causing an immediate reduction in sweating. As a bonus, MiraDry also decreases hair growth in the treated area, according to Dr. Young Cho, a plastic surgeon in Spring, Texas.

In the best-case scenario, one treatment reduces sweat by around 80% and odor by nearly 90%. In her Chicago plastic surgery practice, Dr. Laurie Casas tells patients that they’ll experience a 60–70% reduction in sweating, odor, and hair growth with each treatment.

Question 7

How many MiraDry treatments do you need?

Accepted Answer

Some patients only need one treatment session, while others need two, spaced three months apart.

For people with severe hyperhidrosis, a third MiraDry treatment can be necessary for optimal sweat and odor reduction. If you’re still sweating after MiraDry, another treatment session may help.

Question 8

What happens during MiraDry treatments?

Accepted Answer

You’ll be instructed to shave your underarm hair 4–6 days before your MiraDry procedure and not to shave after that, so some hair is visible. “This will help identify the area to be treated, as your hair-bearing regions coincide with the sweat and odor glands,” says Dr. Cho.

A MiraDry procedure takes less than an hour, but Dr. Cho advises patients to add 20–30 minutes for numbing and preparation.

While every appointment may vary slightly, here’s what you can generally expect:

At your provider’s office, your armpits will be marked with a template that resembles a tattoo, which is used as a guide when the heat is applied.
Local anesthesia will then be injected into both armpits to numb the area, as well as to “inflate” your skin and provide a cushion between your sweat glands and the heating device. Many patients say this is the most painful part.
Once the area is numb, the anesthesia allows for “a very comfortable procedure with very low risk of injuring underlying nerves,” says Dr. Susan Van Dyke, a dermatologic surgeon in Paradise Valley, Arizona. “The effectiveness of the treatment is also increased because higher energies can be used more safely.”
During the treatment, you’ll feel suction but not pain. The system simultaneously cools the skin as it’s heated, so the procedure “is very tolerable,” Dr. Cho says.
The handpiece will pass over the treatment area, gently suctioning the skin in order to bring the sweat glands closer to the surface and make them more accessible to the heat.

Question 9

What can you expect during MiraDry recovery?

Accepted Answer

You won’t need much downtime after a MiraDry treatment, but you can expect some localized soreness and swelling that may linger for a couple of weeks.

Bruising and redness are common, and some numbness is normal. “Some nerves are very close to the surface of the skin and may be affected transiently by the heat energy,” explains Dr. Cho. “This is temporary and resolves with time.”

Most doctors say you can go back to normal activities after your treatment, but taking a couple of days off work wouldn’t hurt. “If you’re a weekday worker, my advice is to take the last [appointment] slot on a Friday afternoon,” says Brisbane, Australia, dermatologist Dr. Davin Lim. That way you’ll have the weekend to rest before going back to the office.

Your provider will give you MiraDry aftercare instructions. For the quickest recovery, apply ice packs on and off for the first 24–48 hours, and take over-the-counter pain medication as recommended by your provider.

It’s also advised to avoid heavy lifting, running, or intense exercise for at least a week post-treatment.

Question 10

Does MiraDry work?

Accepted Answer

In short, yes. The company that makes MiraDry touts the results as immediate, and that patients see an average sweat reduction of 82% at 12 months post-treatment. Some reviewers on RealSelf agree that results are instantaneous, while others say they will take a few days.

Wait a few days to see the effects of your first session before you decide whether to undergo another treatment.

One RealSelf member said in her review that she noticed a “permanent reduction in sweat, odor, and hair in my underarms after one treatment.” She added that MiraDry was painless and “worked better than I thought.”

The upshot: You’ll still sweat in other parts of your body, but your underarms won’t need platinum protection.

Question 11

How long do MiraDry results last?

Accepted Answer

The results will likely be permanent. Research shows results last for at least two years and likely much longer. Once the thermal energy has destroyed your sweat glands, they won’t regenerate, though multiple treatments may be necessary.

“About 20–30% of patients may benefit from a second treatment to get optimal results,” says Dr. Cho. If you still notice wetness and odor after one session, talk to your doctor about whether repeat treatments will help you reach your goals and how many would be necessary.

Doctors on RealSelf say it may take up to three sessions, several months apart, before you can ditch your deodorant or antiperspirant altogether. In these cases, doctors will often offer discounted follow-up treatments.

Question 12

Is MiraDry safe?

Accepted Answer

MiraDry is generally considered to be very safe. After a treatment, it’s common for your underarms to be swollen, sore, or have changes in sensation like tingling or numbness.

These issues aren’t usually serious and often clear up in a few days or weeks, though Dr. Cho says persistent numbness may take up to several weeks to resolve.

Because there are other potential MiraDry complications associated with the numbing process, it’s important to go to a physician-supervised office where the amount of numbing medication you can tolerate is safely measured and the staff has been trained in safe injection techniques. “Going too deep can cause potential transient muscle weakness,” says Dr. Cho.

Question 13

What are the alternatives to MiraDry?

Accepted Answer

Short of surgically removing or injuring the sweat glands so they can no longer produce perspiration, there are other treatment options to help control hyperhidrosis.

Prescription oral medications called anticholinergics work throughout the body to prevent the stimulation of sweat glands and decrease overall sweating.
Qbrexza is a prescription medicated wipe that contains an anticholinergic formulation. It works by blocking receptors responsible for sweat gland activation.
Botox, Dysport, and other neurotoxins can also be injected into the underarms, hands, or feet to stop wetness for 3–6 months.

Question 14

Sources & studies

Accepted Answer

Doolittle, James, et al. “Hyperhidrosis: an Update on Prevalence and Severity in the United States.” Archives of Dermatological Research, vol. 308, no. 10, 2016.

Hong, Chih-Ho H., et al. “Clinical Evaluation of a Microwave Device for Treating Axillary Hyperhidrosis.” Dermatologic Surgery, vol. 38, no. 5, May 2012.

Lupin, Mark, et al. “Long-Term Efficacy and Quality of Life Assessment for Treatment of Axillary Hyperhidrosis With a Microwave Device.” Dermatologic Surgery, vol. 40, no. 7, July 2014.

“Miradry Treatment for Focal Axillary Hyperhidrosis.” ClinicalTrials.gov, Johns Hopkins University, 2014.

Tan, Stephen R., and Nowell Solish. “Long-Term Efficacy and Quality of Life in the Treatment of Focal Hyperhidrosis with Botulinum Toxin A.” Dermatologic Surgery, vol. 28, no. 6, June 2002.

MIRADRY

Young R. Cho, MD, PhD

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Young R. Cho, MD, PhD

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