BOTOX vs. MiraDry: What’s the Best Option for Reducing Underarm Sweat?
Posted on August 9, 2024 | by Boston Plastic Surgery
Underarm sweat has terrible timing. It’s at its worst when we’re stressed out, in close quarters, or both—and any resulting sweat stains and odor only serve to stress us out more. Antiperspirants can help, but they come with drawbacks: they contain chemicals that not everyone is comfortable with, they leave marks on clothing, and they often don’t hold up to the demands of our day.
The good news is that we have two treatments that can reduce or eliminate underarm sweat: BOTOX® injections and MiraDry®. We offer both at Boston Plastic Surgery, and many of our patients ask which is best. While the exact answer requires an in-person consultation—each patient has unique needs and goals—we thought it might be helpful to outline the pros and cons of BOTOX vs. MiraDry.
What’s involved with BOTOX for sweating vs. MiraDry?
BOTOX injections for excessive sweating (a.k.a. hyperhidrosis) are similar to BOTOX for cosmetic purposes, only injections are made in the armpits. BOTOX works by blocking nerve signals to the sweat glands, so when your brain says “start sweating,” your glands don’t respond. Injections take about 30 minutes, and topical anesthetic can help offset the discomfort of injections, which feel like a brief bug bite.
MiraDry is an energy-based, non-surgical treatment. The armpits are numbed with anesthetic, and a handheld device emits microwave energy through the skin, which heats and destroys the sweat glands. Treatments takes about 1 hour, and most of our patients find treatment easily tolerable with little discomfort, especially since we changed to an improved numbing technique. Neither option requires downtime.
What results can I expect with BOTOX? What results are possible with MiraDry?
Both treatments can achieve significant sweat reduction within a few days after treatment. BOTOX studies report that most patients experience greater than 50% sweat reduction, and many achieve up to 80% reduction. MiraDry studies report similar or better results: one study showed around 80% sweat reduction as soon as 3 months after treatment.
MiraDry offers benefits beyond sweat reduction. Because the sweat glands are destroyed, they can’t produce odor anymore—many patients feel confident without wearing deodorant at all after treatment. Also, the heat from the MiraDry device can disable hair follicles, and many patients have experienced a reduction in underarm hair as a pleasant side effect. BOTOX injections do not offer these benefits.
How long will results last with each treatment option?
Sweat reduction from BOTOX typically lasts about four to six months. Patients will need re-treatment every 6 to 8 months to maintain the effects.
Results achieved with miraDry last indefinitely, because the sweat glands do not grow back after treatment. Although there is significant reduction (in the range of 80-85%) from the first treatment, some patients choose to have a second treatment, usually a few months later, to achieve the most complete sweat reduction possible. A third treatment would only be needed for severe cases of hyperhidrosis.
Is miraDry safe? What about BOTOX?
Both miraDry and BOTOX are FDA approved to treat excessive underarm sweating. For the right patients, both treatments are safe in the hands of an experienced medical provider.
Energy-based treatments have been used safely and successfully for years in medicine, and miraDry emits controlled levels of microwave energy in a localized area. Likewise, BOTOX has an excellent safety record for use as a cosmetic and therapeutic treatment. The neurotoxin in BOTOX is carefully measured and diluted so that it spreads only to the nerve endings in the intended treatment area.
Possible side effects with miraDry include: temporary swelling, numbness, and tingling in the armpits. Serious complications, such as prolonged loss of sensation in the armpits, are rare. Possible side effects with BOTOX injections include: temporary swelling, soreness, and numbness. Serious complications, such as muscle weakness, difficulty swallowing or breathing, or blurred vision, are rare.
The verdict: for most patients, miraDry comes out on top
BOTOX has been used to treat excessive sweating for many years, and it still may be the best solution for some patients. However, miraDry offers longer-lasting results plus the added benefits of odor and hair reduction. The best way to determine the right solution for you is to talk with a healthcare provider who’s experienced in both BOTOX and miraDry.
If you are in the Boston area and interested in learning more about your options to stop underarm sweat and live without the hassle of antiperspirant, we’ll be glad to help. Contact us today to schedule a personal consultation with either Dr. Samaha or our board-certified physician assistant, Aliza Holstein, MS, PA-C.
Apart from facial treatments, Botox can also be used to treat hyperhidrosis, also known as excessive sweating. This refers to an abnormal amount of sweating in any part of the body and can’t be remedied by antiperspirants. Botox is injected into the area where you sweat excessively and will relax the overactive sweat glands. The procedure only takes a few minutes, depending on the area where you’ll get injected and it will take over a week for total dryness to occur.