Miradry vs Iontophoresis

Do you suffer from excessive underarm sweating? It might actually be a medical condition called hyperhidrosis. Studies show that people with hyperhidrosis have a severe negative impact on their life quality and suffer a lot and struggle to handle their sweating on a daily basis. It is not "just a little sweat". Are you looking for and effective solution to treat this condition? There are actually many useful treatments for underarm sweating. Two treatments where clinical data has shown good results are Miradry and iontophoresis. I have written this article to compare these two. Please also see the table for an overview.

Miradry treatment is often seen as the lasting solution when it comes to hyperhidrosis treatments. Miradry uses microwaves to "boil" the sweat glands under the skin which deactivates them. First a consultation at the physician's office to see if you are a good candidate for this treatment and could benefit of Miradry. Local anesthesia is injected under the skin of the target area before treatment. Miradry has shown great results with reduction of sweat and improvement of life quality in up to 90% of the treated patients. After treatment common side effects are swelling of underarm skin as well as numbness and/or pain. Painkillers are usually needed at least the first few days. Many patients need to repeat the treatment one more time before seeing the long term results. Even in those cases the sweating can reoccur after a few years. Although long-lasting side effects are rare, they do occur and usually consist of altered sensation of the treated area, so called neuropathy. Another aspect of the Miradry treatment is that it is quite expensive. Prices vary from country to country but around 2000 USD is a common price for the first session and half of that for the second. Many people within the hyperhidrosis community are wondering if Miradry will be used for other areas of the body as well, apart from the underarm area. A few clinics are currently using Miradry for off label treatments to treat the chest of back area, often in those who suffer severe compensatory sweating after ETS sugery.

Many hyperhidrosis patients suffer from palmar and plantar hyperhidrosis which means excessive sweating of the palms and feet. At this stage no one knows for certain but if you ask me, I think it will be hard to use the current Miradry technology on these two areas in a safe way. This is because the skin is thin and the palms and feet are full of small sensitive nerves that risk being harmed during the treatment with the risk of permanent damage. So I believe that miradry treatment will be reserved for the armpits in most cases and maybe for back and chest in a few experienced clinics.

As for tap water iontophoresis treatment iontophoresis devices are a type of medical device suited both for clinic but even more for home use. In many countries anyone can just buy their own device without a prescription from a doctor (the USA is one of the countries where a prescription is required). Iontophoresis is one of the oldest treatments for hyperhidrosis and has been around for decades. The mechanism of action is not yet fully understood but some hypothesis are that the ions from the water form a mechanical block to prevent the sweat from coming out, that the electrical properties of the neurons connected to the sweat glands are altered etc.

Treatment is performed by filling up two plastic containers with tap water. Then one electrode is submerged in the water of each plastic bin. The electrodes are connected to the device itself and the hands/feet and placed on the electrodes, one on each. For treating the underarm area, the electrodes are soaked in water and then placed under each arm. Then a mild current is passed through the skin of the treated area for 20-40 minutes. This is performed daily until desired results are seen which i usually efter 1-2 weeks. Then you switch to maintenance schedule and treatments are usually performed 1-3 times per week to maintain the effect. Side effects are mild. Blushing of the area can occur. Too high current that is painful should always be avoided to avoid skin damage.

Although iontophoresis is considered a little time consuming by some, it is an effective treatment with good results and few and mild side effects as well as cost effective. An iontophoresis device usually costs around 400-500 USD and can last for 10 years when handled with care.

Please know that hyperhidrosis affects about 1-5% of the world population. You are not alone in this struggle. I don't recommend ETS surgery due to the risk of severe and permanent side effects. Please read more about different treatment options and make sure you try different things until your find the method that gives you the best results.

Looking to compare Miradry and iontophoresis to see what option suits you best? Here is a full comparison chart to make your choice easier: