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Ultherapy® for Hyperhidrosis

Cosmetic Hyperhidrosis is excessive underarm sweating. It is very common and ranges from being a daily nuisance or embarrassment for some to in more severe cases significantly impacting a person’s daily life.

Some patients are simply bothered by their underarm sweating and have to frequently apply antiperspirant and worry about staining or ruining clothes. Some experience social or professional anxiety about this and it impacts also their choice of clothing and activities. Weddings for example may be especially challenging for brides.

Various treatment options are available, including antiperspirants and Botox®. These typically try to temporarily disable the sweat glands for various durations and require repeated treatments to maintain effectiveness. A newer therapy called MiraDry® has FDA approval for hyperhidrosis and offers a longer lasting solution but may be relatively painful. Some other options include older surgical procedures which had some significant side effects and risks. Newer procedures include the use of laser cannulas to disrupt or destroy the sweat glands.

Ultherapy® utilizes ultrasonic energy to disrupt or destroy sweat gland activity under the arms. It uses focused sound waves to target the depth of the skin where the sweat glands are located and the areas of their activity can be visually mapped out with a simple starch-iodine test. Ultherapy has been used widely for lifting and tightening skin and has FDA marketing approval for use as a non-invasive dermatological aesthetic treatment to lift the eyebrow and lift lax submental (beneath the chin) and neck tissue. Currently, the use of Ultherapy for hyperhidrosis is an FDA off-label use.

Clinical studies to date have shown good efficacy with minimal side effects and reduction in sweating has persisted for a year or more in the majority of cases. Two treatment sessions about one month apart are advised for most cases. One treatment may give relatively dramatic results in some cases, but longer lasting results seem to be significantly more likely with two treatment sessions. Injections of a local anesthetic solution are performed before the treatment and typically there is little discomfort although some sensation of heat will be experienced if an area that is not totally numbed is treated. Treatments are performed in an office setting and most patients may resume their normal routine activities the next day. Some tenderness or soreness or bruising may occur and some people experience some transient tingling or sensory change.

Recent studies show over half of the treated patients were satisfied and over a third were very satisfied. A little less than 10% were dissatisfied and most of them experienced reduction in sweating but did not achieve their personal goals with the two treatment sessions.

Unlike traditional surgery, Ultherapy treatments are performed in the office without general anesthesia. Procedures typically take about an hour though this may vary depending on the areas being treated.

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