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.

Citations
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

Charlotte Kulkin, RN, CNS, FNP-BC

Charlotte Kulkin, RN, CNS, FNP-BC, is a Family Nurse Practitioner licensed by the State of Georgia, and the Georgia Composite Medical Board. Charlotte has more than 30 years of experience in primary care, critical care, and cardiac rehabilitation. She currently serves as WIFH’s miraDry® specialist, performing over 600 miraDry® procedures since 2015.