Why can't radiofrequency microneedling be used to treat hyperhidrosis on the palms or feet?

Question

I have heard RF microneedling can be an effective way to treat primary axillary hyperhidrosis. Why is it not the case for the palmar and plantar hyperhidrosis? What makes it effective/safe to use for the underarms but not other areas, and are there any options currently that can permanently treat hyperhidrosis on the palms and feet? I have hyperhidrosis in all three areas and was wondering what options I have to treat them.

Steven F. Weiner, MD · Answer

Contrary to other answers, RFM is very successful at treating axillary hyperhidrosis and I have written a paper about this. It gives long-term results that has high satisfaction rates. The hands and feet have many nerves and muscles which can be injured with the RFM whereas the axilla is free of these issues at the depths treated. Hands and feet are also very painful to inject so I imagine the RFM is even more painful. I was one of the innovators of the axillary treatments and developed protocols too.

Amy Y. Paul, DO, FAAD · Answer

Thanks for your question.  RF microneedling is not effective for treating excessive or even regular sweating of the underarms.  It is also not effective in treating excessive or regular sweating of the palms and soles.  One system that is very effective and eliminates excess sweating, odor, and hair of the underarms is MiraDry.  We hope one day that MiraDry will be also able to be used on the palms and soles, but so far that is not the case.  Botox can be injected by your dermatologist to temporarily decrease sweat and can be used in the palms and soles, and there are a few topical medications that can help but are also not permanent.   There is not yet a permanent solution for palm and sole hyperhidrosis, but hopefully someday there will be!  The energy delivered by radiofrequency is a completely different wavelength and strength of energy than the energy delivered by MiraDry, and can't be compared.  It would be wonderful if RF microneedling also eliminated sweat, but presently it is only effective in helping improve skin tone and texture on the face, neck and sometimes on other areas of the body, but not specifically for underarm sweat, or sweat on the palms and soles.  Please see an expert, and best of luck!

Why can't radiofrequency microneedling be used to treat hyperhidrosis on the palms or feet?

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Why can't radiofrequency microneedling be used to treat hyperhidrosis on the palms or feet?

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