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Microwaves Against Hyperhidrosis: Clinical Experience

More recently, cosmetologists could offer only short-term treatment to patients with increased sweating in the armpits. The application of the new hardware technique has opened up new possibilities: now, to eliminate the problem, one procedure is forever enough.

Axillary hyperhidrosis – excessive sweating in the axillary region. According to studies (Glaser et al. 2012), this condition is observed in 33% of the population. At the same time, the majority of patients with particular discomfort are not sweating in itself, but the unpleasant odor accompanying it.

There are two types of sweat glands: eccrine and apocrine.

Eccrine glands produce a transparent, odorless sweat designed for thermoregulation. Apocrine glands secrete a secretion of milk consistency, which when decomposed by bacteria creates a special body odor. It can be perceived by others as unpleasant. Both types of glands are located near the border between the dermis and subcutaneous fat (TFA).

Antiperspirants and deodorants: benefit or harm?
Patients usually begin the fight against hyperhidrosis with the purchase of specialized hygiene products. However, according to recent FDA studies, most deodorants and antiperspirants contain triclosan as the active ingredient. It really destroys bacteria that cause an unpleasant odor, but with them – and healthy skin flora. Triclosan is able to penetrate the body through the pores and thereby cause a malfunction of the reproductive and endocrine systems.

Aluminum salts contained in antiperspirants can even trigger the appearance of cancer cells and worsen the condition of bones and teeth.

After the publication of these studies, more and more patients began to seek treatment for hyperhidrosis in aesthetic medicine clinics (Solish et al. 2005). However, botulinum toxin injections and surgery (sympathectomy) also have disadvantages. In the first case, it was impossible to achieve a lasting effect, in the second – had to deal with possible side effects.

treatment of hyperhidrosis with MiraDry
Microwave energy as a source of heat
The use of microwave energy in the treatment of patients began in 1946. However, until now, these techniques are less familiar to the medical community than laser, radio frequency, and ultrasound.

Microwaves mean electromagnetic radiation with a frequency of 300 MHz to 300 GHz. This frequency range transfers energy to tissues through absorbed radiation, causing dielectric heating. At the molecular level, it is a rapidly changing electric field induced by microwave radiation; this field affects the dipole moments in the water molecules present in the tissue. The molecules are excited by the microwave field, which leads to tissue heating and the difference in dielectric properties between the skin and adipose tissue. At the border between them, a large amount of reflected energy is generated. It returns back to the emitter, which creates an optimal interference pattern with the initial radiation. The result is interference, that is, a summation of the intensity of electromagnetic waves in the transition zone of the skin (dermis) in the pancreas, and destructive interference near the epidermal layer.

Clinical experience with microwave thermolysis of sweat glands for the treatment of hyperhidrosis
In the Estelab clinic, we use the MiraDray system (MiraDry, USA), designed specifically for the treatment of axillary hyperhidrosis.

Diagnostics
Before the procedure, the intensity of perspiration was assessed on a 4-point HDSS scale by questioning the patient. A weight estimate was used as secondary.

To visualize the problem area, the starch-iodine test was used, the Minor test

Minor test before process
Minor test before the procedure.

Minor test after the procedure

Absolute contraindications were taken into account: wearing a pacemaker, using oxygen in cylinders.

Procedure
The procedure includes three stages

treatment of hyperhidrosis with MiraDry
. Local anesthesia (1% lidocaine with 1: 100 000 adrenaline over the entire area of ​​the treatment area; dosage of anesthesia -).

Patient satisfaction has reached over 90%, which confirms the global statistics of the effectiveness of MiraDry; Real Self “Worth It” ratings 2018). We also took into account the proportion of patients in whom, after treatment, the odor in the axillary region that was felt before treatment disappeared.

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