miraDry

miraDry is a minimally invasive, in-office procedure designed to reduce underarm sweating (axillary hyperhidrosis). The system uses microwave energy delivered by a specialized handpiece to destroy sweat glands in the underarm. The miraDry device was cleared by the U.S. Food and Drug Administration in 2011 for the reduction of underarm sweating.

The treatment is performed under local anesthesia. The clinician marks the treatment area and delivers energy to multiple sites to cover the underarm, with cooling and protective measures to the skin. A typical session lasts about 60 to 90 minutes per underarm, and most patients are able to return to normal activities the same day.

Effectiveness varies among individuals, but many patients experience a substantial reduction in underarm sweat, commonly reported in the range of 50% to over 80% after one treatment. Some patients may require a second treatment to achieve the desired result. The effects are generally long-lasting, since sweat glands do not regenerate, though results can vary and some patients may notice gradual return of sweating over time.

Common and temporary side effects include pain or discomfort during the procedure, swelling, tenderness, numbness or altered sensation in the underarm, and mild bruising. Most effects resolve within days to weeks. Serious complications are rare. Proper patient selection and technique are important to minimize risks.

Cost and access vary; miraDry is often not covered by insurance and is paid out-of-pocket or through cosmetic coverage depending on policy. It is intended for adults with clinically significant axillary hyperhidrosis who have not responded adequately to topical agents; alternatives include topical antiperspirants, oral medications, botulinum toxin injections, iontophoresis, and surgical options in selected cases.