miraDry is `Life Changing` For Hyperhidrosis Patients Says Dr Carolyn Jacob

Posted on the 17 February 2015 at 09:50

miraDry® is a safe, clinically proven, FDA-cleared solution for significantly reducing underarm sweat. It is the only FDA-cleared procedure that provides a lasting reduction of axillary hyperhidrosis in a completely non-invasive way.

miraDry® delivers precisely controlled electromagnetic energy to the region where the underarm eccrine glands reside, which heats the sweat glands and eliminates them for good. The device won The Pinnell Award for Product Innovation at the Aesthetic Awards 2014.

Dr. Carolyn Jacob has authored a paper on the development of the miraDry® system and presented at clinical meetings around the globe. I caught up with her to find out more:

What is your experience and your history with using the miraDry® system?

I’m the Director of Chicago Cosmetic Surgery & Dermatology in Chicago, Illinois, and we’ve had the miraDry device since January of 2012.  The number of patients that come to us now, because of hyperhidrosis, has increased 300% since we obtained the device.

We treat about 15 patients a month, and patients need two treatments, spaced apart by three months, to have about a 90% reduction in the amount of sweat that they have.

I find it absolutely incredible to realise how many people are out there with this problem who don’t seek help until they find out on the internet that there’s now a treatment that can give them a lasting result.

Do you think that perhaps hyperhidrosis is the new acne; by that I mean that people can suffer with acne for a very long time and never realise that they can find a solution?

Not as many people have hyperhidrosis as have acne. About 30 million it’s estimated in the United States have hyperhidrosis, however the amount to which it bothers them is greater, it is considered more embarrassing than having acne, because so many people have acne, it’s become a little bit more commonplace. This (hyperhidrosis) seems to be more like a silent sufferer type of condition.
And so I think now that people can go on the miraDry website and find that there’s a treatment to get rid of this, they actually seek out help.  Whereas before they thought there wasn’t anything they could do about it, so we weren’t seeing as many patients.

Do you generally find that you’re seeing a broader range of patients, men as well as women, differing age groups and social profiles?

Absolutely. So the age range for our patients that have used Miradry spans from 13 years old to 72. 

As we know a lot of people with hyperhidrosis develop the condition at puberty and there’s one particular young girl who was given permission by her mother to have the treatment done because she’s an actress and there was a lot of problem with the sweating. So she’s doing much better, which is wonderful.

Most of the patients are between 25 and 50 years old and most of them are new to our practice. There is probably 60% women and 40% men. So it’s actually something that a lot of men have an issue with and this is a treatment that they definitely want to seek out so they can stop ruining their clothing.

We know that there are other treatments available for hyperhidrosis, such as stronger anti-perspirants, botulinum toxins and iontophoresis. What are the advantages that miraDry brings to patients that aren’t available with the other treatment options?

Treatment with miraDry

So other treatments for hyperhidrosis are temporary, or they may have adverse effects, like the topical anti-perspirants may cause some irritation or rashes to the skin.

Botulinum toxin (Botox®) injections are not covered by health insurance most of the time (in the USA), and it’s very expensive because it has to be repeated every six to nine months because it wears off. Plus it does require needle injections and a lot of people don’t want to have repeat needle injections.

There’s pills that one can use and the pills do work, however for some people they have to take such a high dose of the pills they start to get dry mouth and dry eyes and that’s a problem, because then they have more side effects that don’t make it worth taking the medication.

With the miraDry sensor it’s not invasive, it’s a treatment that can be done on an out-patient basis within 60 to 90 minutes.

Patients have a little bit of swelling for maybe three days or so, but other than that they can do their normal activities.

We just want them to take it easy for a few days afterwards and maybe take some Ibuprofen, but mostly they are back to work and they don’t have a big amount of down time with this and it’s lasting. 

So once they’ve had the treatment done, after two treatments, if they have that 90% reduction it’s going to be permanent because you can’t re-grow these sweat glands.

And you don’t need them either, they’re over-active sweat glands, so just so you know they will sweat normally everywhere else, and you will be able to regulate your body temperature, these are for people who are really sweat bothered or have four to five times the amount of perspiration produced abnormally in their underarms.

miraDry device for treating excessive sweating (hyperhidrosis)

Could you briefly explain the mode of action of the microwave energy that you’re delivering and how that works?




Just like your microwave at home, which heats up water to make your tea, water absorbs the microwave energy because it has a di-pole molecule, one side is positive and one side is negative.

The microwave energy travels across those di-pole molecules, they flip back and forth and the rapid oscillating or flipping back and forth of the molecules creates frictional heat. If you can get that heated up, just like you would when you’re heating your water for your tea in the microwave, to a certain degree it’s going to start destroying the tissue that contains water.

Luckily the tissue that contains water is the eccrine glands or the sweat glands. They’re able (with the miraDry® device) to put this energy right at the base of the lower part of the skin, the dermis, right where it reaches to the subcutaneous fat and that’s where the eccrine glands are located. So it’s basically causing some controlled heat to that area to eliminate the sweat glands.

One of the other side effects of axillary hyperhidrosis is that you can smell, have stale body odour; is the miraDry® treatment addressing this issue too?

They have found, and they have been doing some studies, especially in Japan, where that’s a really big issue, that it does reduce or eliminates the odour. 

Now part of the issue may be that there’s both apocrine and eccrine glands in the same area. Apocrine glands are supposed to be the ones that create the odour, because of the bacteria that live off the gland secretions, but it seems to work (to reduce the odour) in the vast majority of people that get this treatment done to treat the eccrine or sweat glands.

Are you aware of developments that miraDry® (Miramar Labs) have in terms of either future clinical studies or maybe future generations of the device?

One complaint that a lot of people have is that they have hyperhidrosis of their hands. Their hands are a very delicate area, obviously with thinner skin and tendons and nerves that are right underneath the skin. So this poses a little bit more of a challenge (than axillae).

They’re going to look into finding out if they can create a device that can be used either fractionally on the hands, to make it safer, but to still make it work. So they’re hopefully going to be working in development of that, I don’t have more details besides that though.

And then there’s another side effect that we often see which is that some people have a reduction in hair when they do these treatments; for women, it’s a bonus, for men, they don’t really care. So there may be an application for using this modality for hair reduction on people who have light or grey hairs, which of course are resistant to any lasers that we currently have.

Would you go as far as to say that miraDry® is a revolutionary treatment for people who suffer from hyperhidrosis?

This is absolutely revolutionary because it works!

It’s consistent in how well it works, we know that you’re really only going to take two treatments for a great result, very rarely do people need three treatments, perhaps if they have really thick skin.

It is life changing, every patient that I have treated has been so grateful, including one of my best friends and my cousin.

It’s unbelievable the amount of people who suffer from hyperhidrosis, and when they can get this treatment done, and then be fine and not have to worry about that every single day; it changes their life.

Dr Carolyn Jacob

Carolyn I. Jacob, M.D. is a Board-Certified Dermatologist, Harvard-Trained Cosmetic and Laser Surgeon.

Dr. Jacob graduated Suma Cum Laude from Indiana University and earned her medical degree from the University of Illinois at Chicago. She was Chief Resident of Dermatology at University of Wisconsin Hospitals and Clinics and completed a Cosmetic and Laser Surgery Fellowship at Harvard Medical School in 2000. Dr. Jacob’s areas of expertise include lasers for rejuvenation, hair removal, injectable aesthetics, sclerotherapy, tumescent liposuction, non-surgical fat reduction, hyperhidrosis treatments and therapies for photoageing. Her research activities include the investigation and outcomes of various energy based devices, botulinum toxin and products for skin rejuvenation. She has published over 25 articles and 12 book chapters on dermatology and cosmetic surgery.

KnowSweatUK is an anonymous forum where you can discuss excessive sweating and hyperhidrosis with other people who suffer from the condition. It is sponsored by Sweat Smart Centres, who offer a confidential service where you can explore the different non-surgical treatments available for excessive sweating and hyperhidrosis with a qualified professional, such as anti-perspirants, medication, iontophoresis, surgery, botulinum toxin and miraDry.

Follow this link for a list of UK clinics offering the miraDry treatment for axillary hyperhidrosis (excessive sweating).

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