miraDry® vs Botox® for Axillary Hyperhidrosis

There are many products and procedures available to treat excessive underarm sweating (axillary hyperhidrosis), providing various levels of relief.

There are several over-the-counter and prescription anti-perspirants that temporarily reduce the amount of underarm sweat. Because they only provide short-term relief, continuous treatment or application is required to maintain their effectiveness.

Prior to the release of miraDry®, WIFH recommended Botox® injections as a primary treatment for axillary hyperhidrosis due to its effectiveness for up to 6 months. It has been our experience that miraDry® and Botox are the two most effective treatment options for underarm sweating, however the differences between the two treatments are significant, which are outlined below.

Effectiveness for Hyperhidrosis: Botox® vs miraDry®

How does Botox® Work for Hyperhidrosis?

Botox® is best known for its cosmetic use to treat facial lines and wrinkles. However, Botox® can also be used therapeutically for various medical conditions. One of those conditions is excessive underarm sweating (axillary hyperhidrosis)1.

When treating axillary hyperhidrosis, Botox® works by temporarily blocking the signal sent to the brain that turns on the body’s sweat glands. By blocking, or interrupting, this chemical messenger, Botox® ‘turns off’ sweating at the area where it has been injected.”

How long is Botox® Effective for Hyperhydrosis?

While Botox® is effective, it is necessary to continue getting the injections at regular intervals to maintain its effectiveness. Results also vary according to the severity of the condition. In most cases Botox® does not completely stop sweating; rather it greatly reduces sweat production temporarily.

On average 100 units (50 in each underarm) of Botox® will provide up to 6 months of reduced sweat. Worth noting, Botox® only addresses sweat it has no effect on odor.

How does miraDry® Work for Hyperhidrosis?

The miraDry® procedure uses a hand piece that delivers microwave energy to the underarm treatment area. This microwave energy destroys sweat and odor glands in the underarms.

At WIFH, we utilize a tumescent technique for miraDry®. Our Ultra Comfort technology allows us to treat at the highest power the miraDry® device will allow. miraDry is clinically proven to reduce sweating by 82% and odor by 89%, on average2.

How long is miraDry® Effective for Hyperhydrosis?

In sharp contrast to Botox®, miraDry® is a long lasting solution for underarm sweating and odor. Once the microwave energy has destroyed the sweat and odor glands (apocrine and eccrine), they do not regenerate/grow back3.

Cost of Botox® vs miraDry® for Hyperhydrosis

One of the primary considerations when comparing Botox® and miraDry® in the fight against underarm sweating is cost. The truth is, while Botox is definitely less expensive upfront, however miraDry® is the more affordable choice over time.

Cost of Botox® for Hyperhidrosis

Primary factors for determining what the cost of Botox® for axillary hyperhidrosis is, includes the severity of the sweating, the dosage required to treat, and the frequency in which the patient receives the treatments.

This will vary from patient-to-patient but, typically, 100 units are needed per treatment (divided between the armpits). Depending on the treatment facility, you can expect to pay between $1,000 to $1,200 for 100 units. If treated every 6 months, this equates to roughly $2,000 to $2,400 spent in a year’s time. But, because the results are not permanent, you begin gradually sweating more as the Botox® wears off and will need to be treated yet again.

Cost of miraDry® for Hyperhydrosis

While it is generally not covered by insurance, a one-time procedure of miraDry® costs $2,300 to $2,650. We have successfully worked with patient’s HSA plans to pay for treatment, and there are other financing options available.

At WIFH, roughly 10% of patients come back for a second treatment. For patients who opt to have a second treatment to achieve further reduction, WIFH discounts the cost to $995.

From a cost-benefit perspective, miraDry® is a preferred solution for most patients, as they will spend the same amount of money as they would on about a year’s worth of Botox®.

If you’re experiencing excessive underarm sweating and are considering miraDry® vs Botox®, we welcome you to schedule a free consultation for more information.

1. Nawrocki S., Cha J., (2019). The Etiology, Diagnosis and Management of Hyperhidrosis: A Comprehensive Review. Part II. Therapeutic Options. Journal of the American Academy of Dermatology. 2019 Jan 30. pii: S0190-9622(19)30167-7. doi: 10.1016/j.jaad.2018.11.066. https://www.ncbi.nlm.nih.gov/pubmed/30710603
2. Glaser D., Coleman W., Fan L., Kaminer M., Kilmer S., Nossa R., Smith S., O’Shaughnessy K., (2012). A randomized, blinded clinical evaluation of a novel microwave device for treating axillary hyperhidrosis: the dermatologic reduction in underarm perspiration study. Dermatologic Surgery. 2012 Feb;38(2):185-91. doi: 10.1111/j.1524-4725.2011.02250.x. Epub 2012 Jan 30. https://www.ncbi.nlm.nih.gov/pubmed/22289389
3. Li H., Zhou G., Fu X., Zhang L., (2009). Antigen expression of human eccrine sweat glands. Therapeutic Options. Journal of Cutaneous Pathology. 36(3):318-324, March 2009. https://www.ncbi.nlm.nih.gov/pubmed/19032382
About the Author

Christina Imhoff, RN, MSN, ANP-C

Christina Imhoff is a licensed Nurse Practitioner, certified Senior Cosmetic Laser Practitioner, and certified miraDry® Practitioner. She has been performing laser procedures and injectable treatments at WIFH since 2009.