miraDry (microwave thermolysis) for excessive underarm sweating

At a glance

Mechanism of action

Focused microwave energy is delivered through a skin-cooled applicator to the dermal-subcutaneous junction where eccrine sweat glands reside. The thermal effect destroys the glands while the surface cooling protects the epidermis. Once destroyed, sweat glands do not regenerate, producing the procedure's durable effect.

FDA clearance and indication

miraDry holds FDA 510(k) clearance for excessive underarm sweating (and as a marketing claim, for permanent reduction of underarm sweat). The clearance is based on substantial equivalence to predicate devices; trial data document gravimetric and HDSS reductions through 12 months and beyond. The device is in-office only and administration requires trained clinicians.

Treatment course

Most patients undergo one or two sessions, with the second typically scheduled 3 months after the first if more reduction is desired. Each session takes approximately one hour. The treatment area is mapped, anesthetic is injected for tumescent infiltration (to provide local anesthesia and create the thermal-protective fluid layer), and the device is moved across the axilla in a grid pattern.

What to expect post-procedure

Common post-procedure findings: underarm swelling and tenderness for 1-2 weeks, sometimes longer; temporary numbness in the treated area lasting weeks to months; occasional small bumps or lumps as resolution proceeds. Most patients can return to non-strenuous activity the same or next day; strenuous arm activity is typically delayed for a week. The most pronounced effects are usually visible by the 3-month mark.

Outcomes and durability

Clinical trial summaries report sustained gravimetric reductions at 12-month follow-up; longer-term observational data extend further. Because destroyed glands do not regenerate, the effect is durable in a way that Botox's months-long effect is not. Some patients have residual sweating after one session and elect the second; a minority have continued sweating after two sessions and consider additional approaches (Botox, pills that reduce sweating).

Practical considerations

• • Next step: in-office procedure with focused microwave energy
• • Frequency: typically 1-2 sessions, 3 months apart
• • Cost class: high per-session ($1,500-$3,500 per session is typical)
• • Supervision: trained clinician administration only
• • Region: underarm ONLY (FDA clearance scope)

Side effects and reasons this may not be safe for you

• • Post-procedure swelling and tenderness (1-2 weeks)
• • Temporary numbness (weeks to months)
• • Small bumps or lumps that resolve
• • Rare nerve injury (transient)
• • Bruising at injection sites
• • No compensatory sweating (unlike ETS surgery)

Compare this option

• Compare: botox vs miradry →
• Compare: miradry vs brella →

Governed citations

Numbers and approved uses on this page link back to their sources governed in anna-pipeline. Each entry below is a packet bound to this treatment.

Frequently asked

Is miraDry permanent?

miraDry is marketed as producing a permanent reduction in underarm sweat because the destroyed sweat glands do not regenerate. Real-world experience supports durable effect, with most patients maintaining meaningful reduction at long-term follow-up. Whether complete absence of underarm sweat is achieved varies by patient and may require a second session.

How does miraDry compare to Brella?

Both target underarm sweat glands and aim for durable reduction. miraDry uses focused microwave energy and typically involves 1-2 hour-long sessions; Brella uses targeted alkali thermolysis (TAT) delivered as a 4-minute patch application repeated as needed. The /compare/miradry-vs-brella page walks through the side-by-side.

Can miraDry treat hand or foot sweating?

No. miraDry is cleared only for underarm use. The skin anatomy, gland distribution, and underlying nerves on the hands and feet differ enough that the procedure as designed is not applicable to those regions. Hand and foot disease use iontophoresis, Botox, and other options.

Reading paths

• Check your severity with the HDSS calculator →
• Body regions →
• How claims are governed →

When this treatment is usually considered