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07-06-18 | Posted by

Sweaty underarms can ruin a designer silk dress, are a real buzzkill on a first date, and can destroy your confidence before a career make or break a presentation.

Heat and humidity invariably cause perspiration for the best of us. But for people afflicted with the annoying medical condition called ‘hyperhidrosis,’ this becomes a very serious problem. About 2-3% of the population suffers from excessive sweating, but nearly all of us would rather not smell or sweat if we don’t have to.

There are some good treatments available now, and more on the way.

BOTOX has been FDA cleared for treating excessive sweating all the way back to 2004. Basically, it works by stopping nerves from firing by blocking the uptake of acetylcholine, one of the neurotransmitters that tells muscles to contract. The treatment is pretty straightforward and by all accounts, it works brilliantly. Dr. Stanley Kovak of the Kovak Cosmetic Center of Oakbrook, IL explains how this works. “BOTOX works very predictably to reduce sweating. We use about 10 to 15 tiny injections into each underarm area through a very fine needle. Patients will start to see results in 4 weeks or less, and the effects can last about 6 months.”

According to New York City dermatologist Diane Berson, MD, “For patients with underarm sweating I have recommended a prescription topical liquid called Drysol, and I have performed underarm BOTOX injections which have been very successful for patients and work extremely well. However, there is a new product coming to market that could be a real game changer in that it is a wipe that is applied by the patient in a unique delivery system. It is an Alpha-1 adrenergic inhibitor in topical form developed by Dermira in Menlo Park, CA to target sweat glands, to stop them from contracting and releasing as much sweat. What is unique is that the delivery system will be in the form of a wipe. It has the same mechanism of action as a product that was previously available only through injections. This drug, called Qbrexza, has gained FDA approval and will be available this fall. It is very exciting that we will have a new addition to our armamentarium.”

Miradry is another way to go if you don’t want to sweat anymore. This novel first of its kind treatment uses miraWave energy (like a microwave) to target and destroy sweat and odor glands under your arms. Once those glands are destroyed, they are pretty much gone. An added benefit of Miradry is that its latest FDA clearance builds is for the treatment of underarm sweat and for the permanent reduction of unwanted underarm hair of all colors.

New York City board-certified plastic surgeon, Sachin Shridharani, MD, who is one of the largest providers of miraDry in Manhattan, has seen impressive results. “The miraDry procedure has an extremely high patient satisfaction and takes approximately 1-1.5 hours to perform. Patients can resume most normal daily activities right away. There will be some swelling for a few days, but the results are immediate and permanent. Most patients find that after the first or (sometimes necessary) second treatments, daily use of antiperspirant or deodorant is no longer necessary because there is no more odor or sweat. We are finding patients have longevity and permanence of the procedure.”

With 2-4 million eccrine glands in the human body, we all have plenty to spare and won’t miss them, although my dry cleaner surely does… Full disclosure: I had a single treatment session of miraDry about 5 years ago with New York City plastic surgeon Dr Bryan Forley, and have recommended it to about a zillion people since. The effects for me were instant as promised; I literally had no odor and practically no wetness immediately after treatment and the results are still going strong.


NOTE: Miradry treatment was offered by the company for trial at the time. All opinions are my own.



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