Ultherapy for Excessive Sweating (Hyperhidrosis Treatment)?

Do doctors recommend trying to use Ultherapy treatment for excessive underarm sweating / axillary hyperhidrosis? I realize it's not FDA approved for this problem, but I'm keen on avoiding botox treatments and want something more permanent.

Doctor Answers 7

Ultherapy for axillary hyperhidrosis

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I have used it once, off label, for a patient who traveled from Singapore to have it done for this indication. I have a large hyperhidrosis clinic and perform every described procedure for hyperhidrosis. This particular patient had suction curettage TWICE in SIngapore and had recurrence. She traveled to Japan and had 2 miraDry procedures and an attempt with subdermal laser ablation. All of these procedures failed to eliminate the hyperhidrosis. She had residual dampness which bothered her. I performed miraDry at level 5 a day after I used Ultherapy. The procedure was successful and I can't tell if it was the miraDry or Ultherapy or both that helped this patient. 

It should be remembered that this is an off label use for this device for hyperhidrosis and should only be used in unusual circumstances when other techniques have failed to relieve hyperhidrosis.

I developed a comprehensive Center for Excessive Sweating in 1999. 

Ultherapy has not been cleared for underarm sweating, unlike Miradry

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Although there may be an effect of reduction in perspiration from surgery on the nervous system, as well as dermal liposuction and  (scraping) procedures and excision of the affected skin, there has been a stimulus for the development of non-invasive treatment for axillary hyperhidrosis. Ultherapy does not have such clearance and I have not used it for this purpose. I am not aware of studies investigating the safety of Ultherapy for this condition, but MiraDry is a noninvasive electromagnetic energy delivery system that heats up and destroys the sweat glands. It may take more than one treatment and usually local anesthetic is used. Although I have not yet incorporated this treatment in my cosmetic practice, I am aware of a high percent of sweat reduction in the majority of patients involved in one of the initial studies done on this device.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Treating Excessive Sweating

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Thank you for your question. Currently, Botox is used for excessive sweating of the underarms, and has had great success in treating this issue. As of now, Ultherapy has not yet been approved. I would suggest receiving Botox injections until Ultherapy is approved.

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Ultherapy is currently being tested for FDA approval

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Ultherapy is currently being tested for FDA approval for hyperhidrosis. While several doctors are already using it for this indication, the data for how effective it is and for how long the results last has not yet been determined. Botox treatments work very well for hyperhidrosis and results tend to last 6 – 12 months. This is a good alternative until Ultherapy has been approved for this indication. If Ultherapy does work for hyperhidrosis, it is unlikely it will be permanent.

Joseph A. Eviatar, MD, FACS
New York Oculoplastic Surgeon
4.7 out of 5 stars 68 reviews

There is a better long term FDA approved option: it is called miraDry

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There is anecdotal reports for making sweating better but it has not been studies vigorously.  I have an ulthera device in my practice.  But the better option is miradry.  it selectively heats up the sweat glands, it is FDA approved, and thousands of patients have been successfully treated upto date

Cameron Rokhsar, MD, FAAD
New York Dermatologic Surgeon

Ulthera does work for hyperhidrosis in one study by Dr. Nester

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There was a poster presentation at a conference I was at describing very significant improvement in the sweating scores after 2 treatments of Ulthera for axillary hyperhidrosis.  The proposed way it works is by destroying the sweat glands with the ultrasound from the Ulthera.  It requires lidocaine injections to numb the area treated, just as the Miradry device does.  The study was done by Dr. Nester from South Florida.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.9 out of 5 stars 75 reviews

MiraDry, not Ultherapy for Underarm Hyperhidrosis or Excess Sweating

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Hyperhidrosis or excess sweating affects significant portion of the population. While there are several medical remedies such as Drysol (alumninum chloride), tannic acid soaks, iontopheresis, and Botox, there is only one FDA-approved modality for lasting solution to excessive sweating and it is MiraDry, not Ultherapy. MiraDry utilizes proprietary microwave technology to obliterate apocrine and eccrine glands. Therefore, not only is MiraDry effective for excessive sweating, it is also efficacious for dramatic decrease of body odor. On the other hand, Ultherapy is a revolutionary way to bring out face and neck tightening utilizing ultrasonic technology which allows for visualization of skin tissue and muscles prior to delivery of therapeutic energy.

William Ting, MD
Bay Area Dermatologic Surgeon
4.5 out of 5 stars 14 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.