Hyperhidrosis is the medical term for excessive sweating. Most of the time excess sweating is localized to the armpits, hands and/or feet but it can be generalized. Oftentimes stress or anxiety can trigger excess sweating, but it can be present throughout the day, significantly affecting your daily activities and confidence. Patients that come to us for this treatment often complain of sweating through their shirts, having yellow stains in the underarm areas of shirts and dresses, and suffering great embarrassment due to wet marks on clothing.
There are different ways to manage localized axillary (armpit) hyperhidrosis. Dr. Hooman Khorasani offers effective, in-office procedures that can address your concerns.
To find out which sweat and odor reduction treatment Dr. Khorasani would personally recommend for you, visit us at our New York City practice. To request a consultation, message us securely, or contact Dr. Khorasani’s Manhattan office by phone at 347-574-8500.
BOTOX is a protein that is injected into the skin which locally blocks the sweat signals. This treatment prevents sweating in the injected location only. A series of small injections are performed in a grid-like pattern. With some numbing cream most patients tolerate the procedure very well. Sometimes you may experience bruising or swelling in the area for a few days. You will start to see the effects of these injections within a week. The results from this treatment usually last four to six months, after which repeated injections are needed for maintenance.
This device uses ultrafine needles that penetrate the skin in a stamping fashion. These needles deliver radio-frequency energy deep into the dermis and the subcutaneous tissue. Inturn, this energy is able to destroy the sweat glands and the odor producing glands in the underarm area; thus eliminating sweat and odor. Most patients will need approximately two to three treatments, six weeks apart. This is a good option for patients who cannot afford to have any downtime. It is also Dr. Khorasani’s first choice for treatment in thin patients who tend to not tolerate miraDry as well as patients who are heavier.
miraDry is an FDA approved device to treat hyperhidrosis and provide a permanent reduction in underarm sweat. miraDry works by precisely delivering electromagnetic energy to destroy the sweat glands in the underarm area; thus eliminating sweat and odor. This is a long-lasting solution to treat unwanted, excessive sweating. This is an ideal treatment for someone who is constantly embarrassed about their underarm sweat, conscious about the type of clothing they are wearing and feels like hyperhidrosis affects their daily life. Moreover, this treatment, compared to others, is long-lasting and does not require continuous visits. Results are immediate with minimal downtime. Patients who receive miraDry treatments also notice a reduction in hair growth and underarm odor.
Another effective procedure for hyperhidrosis is liposuction of the armpit (axillary) area. Through this procedure, the sweat and odor producing glands are mechanically removed via liposuction. Axillary liposuction can be done as a standalone procedure, or can be combined with liposuction of other areas as part of a body contouring treatment. This procedure is great for patients who have failed traditional non-invasive treatments and for people who can afford to have some downtime. In addition, there is no need for maintenance treatments- you only need to have this procedure one time.
If you constantly worry about unwanted, excessive sweat or are self-conscious about wet, stained clothing, then you are likely a good candidate for sweat and odor reduction treatments with Dr. Khorasani. If you are embarrassed by underarm sweat outbreaks or believe hyperhidrosis interferes with your daily life, you should schedule a consultation with Dr. Khorasani to determine which treatment is best suited for you.
The treatments that Dr. Khorasani offers either temporarily reduce sweating, or permanently destroy the sweat glands. Depending on which method of treatment is best for your concerns determines the expected results. Some treatments are considered permanent, while others temporarily cease excess sweating.
For example, miraDry provides significant reduction of underarm sweat, and the results are long-lasting. After the first treatment, you should notice immediate, significant results. After two treatments, most patients have an 80% reduction (on average) in underarm sweat. You may also notice a reduction in hair growth and underarm odor. This is considered a “permanent” treatment and does not require more than two visits. BOTOX, on the other hand, is effective after only one treatment, but it is temporary. RF Microneedling has the least amount of downtime but may have to be repeated up to four times. Finally, liposuction is the most permanent procedure but also requires a longer recovery.
The procedure takes about 60-90 minutes. First, your underarms are numbed with a local anesthetic for about 20 minutes. Next, Dr. Khorasani will measure your armpits and select a stencil to be applied to the area. This marks out the treatment zone and dimensions where the handpiece will be treating your skin.
The handpiece is applied to each marked section for about 30 sections. In the first 20 seconds, you will feel like the area is being slightly suctioned, followed by a heating sensation. The suctioning brings the sweat glands closer to the surface, for maximum results. The heat that is felt is the thermal energy being delivered to destroy and eliminate the sweat glands. In the last 10 seconds, you will feel a cooling sensation. This is to ensure that the outermost layer of the skin does not get burned. This process is repeated until all marked off sections of the underarm area are treated.
All in, expect to be at the office for about two hours. You will first be numbed with a topical numbing cream for about 30-50 minutes. Then Dr. Khorasani will review the goals of the treatment with you and customize the settings on the device specific to your concerns and skin type. The procedure itself will take about 25 minutes depending on the area(s) treated. The procedure is not painful, however some discomfort may be experienced. If numbing cream is not enough, Pro-Nox (nitrous oxide), a safe gas that is inhaled to relieve anxiety and reduce the experience of pain, can be self-administered to relieve any discomfort. After the treatment, a serum may be applied to deliver vitamins and nutrients to your skin, to enhance the treatment received and speed up the healing process.
Patients that have hyperhidrosis have overactive nerves that signal the sweat glands unnecessarily. When BOTOX is injected under the arms, it blocks the signals from these hyperactive nerves, paralyzing them so they don’t produce excess sweat. BOTOX is tolerated well by most patients, and you should not experience significant discomfort. Numerous injections are administered by Dr. Khorasani in the axillary area, and it takes about 10 minutes. Most patients have this procedure without any anesthetic, but if you desire, we offer a topical numbing cream that can be applied beforehand, to ensure this is a completely painless procedure. BOTOX injections can reduce your sweating by about 80%; however, you will require ongoing treatments to maintain the desired result.
Before your surgery, Dr. Khorasani will draw markings on your underarm area to indicate where treatment will take place. During the procedure, a small cannula (tube) is inserted under your skin to deliver a solution of saline and numbing medication, called tumescent fluid. It is injected into the area to numb the surrounding tissue. Once this solution is injected, and you are fully numb, a different cannula is inserted under the skin, to suction out the tissue that contains the sweat and odor producing glands, as well as some fatty tissue. There is no cutting involved, and you are awake during the procedure, as it is done under local anesthetic. All in, expect to be with us for about three hours.
This depends on the modality used:
This depends on the modality used.
We recommend that you take an over-the-counter pain medication such as Tylenol, and use ice packs under your arms during the first few days, to mitigate any discomfort. You should also refrain from strenuous physical activity for the first two days following your hyperhidrosis treatment.
No. Only 2% of the 4 million sweat glands in the human body are found in the underarms. In other words, your underarms comprise only a very small percentage of your body’s sweat glands. You do not need to worry about your body overheating or sweating significantly more in other places.
The main difference is whether the treatment you choose is a temporary or permanent solution to your sweating problem. BOTOX aims to temporarily disable the sweat glands for varying lengths of time. Repeated treatments are necessary to maintain effectiveness. Usually, treatments need to be repeated every three to six months, as the results are not permanent. With energy based devices like miraDry® and RF Microneedling the sweat glands are permanently destroyed after the treatment series are completed, therefore there is no need for additional treatments. Liposuction only requires one treatment and is permanent.
It is important to receive this treatment with a qualified, board certified physician. Our office will help you choose the right treatment modality based on the severity of your sweating and the afforded downtime. Particularly with the energy based devices, it is crucial to use appropriate settings so you minimize side effects and reduce your risk of injury. Selecting an energy output that is too strong may cause burning or nerve damage in this area. On the other hand, selecting an energy output that is too low will yield poor results and patient dissatisfaction.
Dr. Khorasani and his highly-specialized team look forward to working with you to transform your medical or aesthetic goals into reality. To expedite a request for a consultation, message us securely, or contact Dr. Khorasani’s Manhattan office by phone at 347-574-8500. For more information about how to get in touch:
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