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·Comparison

miraDry vs Brella SweatControl Patch for excessive underarm sweating

Short answer

Both target underarm sweat glands for durable reduction, but through different mechanisms and treatment burdens. miraDry uses focused microwave energy in 1-2 hour-long sessions; Brella uses targeted alkali thermolysis in a 3-4 minute patch session repeated as needed. miraDry's per-session durability is greater; Brella's individual sessions are shorter and lower-burden.

Side-by-side

CriterionmiraDry (microwave thermolysis)Brella SweatControl Patch
MechanismFocused microwave thermolysis destroys sweat glandsTargeted alkali thermolysis at dermal sweat-gland layer
FDA statusCleared (underarm, marketed for permanent reduction)Cleared (underarm)
Session length~60 min per session3-4 min per axilla
Typical sessions needed1-2Multiple, repeated as effect wanes
Per-session durabilityHigh — gland destruction is permanentMonths; cumulative with repeats
Recovery profileSwelling, tenderness, numbness; 1-2 weeksMild erythema, possible blistering; days
AnesthesiaTumescent local anesthesia requiredTopical numbing typically sufficient
Per-session cost classHigherLower

Which is the better fit when...

Patient wants one-and-done if possible
miraDry comes closer to that ideal: gland destruction is permanent, and many patients are satisfied after one or two sessions. Brella's per-session effect wanes; repeat sessions are typical.
Patient wants the lowest-burden individual session
Brella's 3-4 minute application with topical numbing is the shortest, lowest-burden in-office option in this class. miraDry sessions are ~60 minutes including tumescent anesthesia setup.
Patient cannot take a week off for recovery
Brella's recovery is typically days, not weeks. miraDry's recovery includes 1-2 weeks of underarm swelling and tenderness; the longer recovery is the main practical downside.

Both are newer underarm in-office procedures

miraDry has been available longer (FDA cleared in 2011); Brella is newer. Both are underarm-cleared and not applicable to other regions. Both occupy rung 4 of the underarm order of options alongside Botox; the choice between them is primarily about treatment-session burden vs per-session durability.

Energy delivery differs in important practical ways

miraDry delivers a higher total energy dose per session over a longer time, requiring tumescent infiltration for both anesthesia and thermal protection of the epidermis. Brella's energy delivery is shorter and lower-total; only topical numbing is typically needed, and there is no infiltration step. The mechanical differences explain why session length and recovery experience differ so much.

Frequently asked

Is miraDry truly permanent?
Sweat glands destroyed by miraDry do not regenerate. Most patients maintain meaningful reduction at long-term follow-up. Complete absence of underarm sweat is variable; some require a second session for additional reduction. The marketing claim of permanent reduction is supported but not equivalent to 'zero sweat for life.'
If Brella is shorter and cheaper per session, why choose miraDry?
Cumulative cost and burden over years can favor miraDry for patients who would otherwise need many Brella sessions. miraDry's per-session durability is the main differentiator. For patients who prefer brief in-office sessions and accept the repeat-treatment pattern, Brella is the lower-friction option.

Read each option in detail