I have severe facial cranial hyperhidrosis, I know MiraDry is only approved for armpit excessive sweating. What can I do?

Question

I suffer on a constant basis; people ask me if I am sick, or I've even been asked bluntly if it was because I am currently overweight. I have tried everything including botox and nothing has worked. I have begun to shy away from family and friends, and I no longer even go to the store. If it can be ordered online, I do that. I am being made prisoner of this disorder. I am hoping there is help out there.

Anil R. Shah, MD · Answer

Hello, please see belowThere are a variety of techniques to decrease sweating:Miradry-  Miradry uses microwave energy to destroy apocrine and eccrine glands.  It is better at eccrine gland destruction than apocrine and is currently only used on the underarm area.
RF needling- Can be used anywhere on the body and can destroy both apocrine and eccrine glands.  Has become the procedure of choice in my practice for hyperhidrosis due to its effectiveness.
Nerve ablation-Not commonly performed anymore as side effects are often worse than treatment and effectiveness is often limited.
Oral medications- Too many side effects to be effective.
Topical medications- Works by blocking glands.  Many patients state how not effective mechanism.
Best,
Anil Shah

Aldo Guerra, MD · Answer

I appreciate your question. Cranial hyperhidrosis is a serious medical condition. Botox and Dysport work very well and these are the best treatments I have encountered over 15 years. 
You can consider Botox for the hands, feet, groin and back. 
You should also consider MiraDry for the underarms. These are non-surgical procedures done in the office without the risks of surgery. 
Botox can be used in other places as well.However, I would avoid using MiraDry in the head and neck.
Good luck. Dr. ALDO

Raffy Karamanoukian, MD, FACS · Answer

I have co-authored a book on Miradry and continue to see very positive results for armpit sweating. My office is a regional referral center for hyperhidrosis and I am aware of studies being performed for non-armpit Miradry-like technology. Until the technology gets FDA approved, I would suggest Botox injections for the cranial hyperhidrosis. Best, Dr. Karamanoukian Los Angeles

Sheila S. Nazarian, MD · Answer

Miradry is currently only fda approved for underarms and has a suction applicator so it would not work on your scalp even if it was to be used off-label.  Your other option is Botox injections.

Hratch Karamanoukian, MD, FACS · Answer

Thank you for your question.Botox works great for craniofacial hyperhidrosis.Injection technique is different that Botox injection for wrinkles and migraine headaches. So, it is important to see an experienced provider who treats craniofacial hyperhidrosis.Read my ebook about craniofacial hyperhidrosis on the link below.Dr Karamanoukian

I have severe facial cranial hyperhidrosis, I know MiraDry is only approved for armpit excessive sweating. What can I do?

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