Excessive sweating

In technical terms, excessive sweating is known as «hyperhidrosis» and particularly affects the sweat glands on the hands, feet and in the armpits. These glands produce abnormally high amounts of sweat, which leads to those affected sweating profusely even at moderate temperatures and with little physical exertion. However, the boundary between normal and excessive sweating is blurred; in our view, treatment makes sense when the sweating is significantly disruptive. This could be sweat stains under the armpits of a business shirt or on a T-shirt, damp hands or feet, or sweat on the forehead, scalp or elsewhere.

In Switzerland, around 2–4% of the population are affected by hyperhidrosis. Hyperhidrosis is a complex condition that affects many areas of life: it is not only the physical symptom of excessive sweating, but also the associated social, emotional and psychological challenges. Excessive sweating, especially in visible areas such as the hands, face and armpits, can cause shame and embarrassment. Affected persons often avoid social interactions for fear of being perceived as unattractive or unhygienic. Hyperhidrosis can therefore significantly reduce self-esteem and self-confidence. The fear of sweat outbreaks can also lead to increased stress and anxiety, which frequently worsens hyperhidrosis further.

There are various treatment options for hyperhidrosis. In our opinion, however, two methods stand out as especially effective with excellent results and no significant side effects: a locally acting injectable treatment or miraDry^®. A locally acting injectable temporarily suppresses the secretory mechanism of the sweat glands, so repeat treatments are necessary. miraDry^®, by contrast, is the first FDA-approved method for permanently disabling sweat glands. We do not perform other procedures such as intrathoracic sympathectomy (in which the vegetative sweat fibres in the chest area that are responsible for sweating are disrupted during a larger surgical procedure) or complete excision of the skin and sweat glands under the armpits, because we consider the complication and side-effect rates to be too high. Iontophoresis can be applied to the hands and feet, but it typically requires daily sessions, which many patients do not wish to commit to. Suctioning or destroying the sweat glands with a laser is another option, but outcomes are often moderate.

miraDry^® has revolutionised the treatment of underarm sweating and has largely replaced many prior surgical options. A single treatment is usually sufficient to provide lasting relief. I have personally undergone miraDry^® treatment and am very satisfied with the results.

ULTIMATE DRY: miraDry^® in combination with Morpheus8^®

We have developed an exclusive upgrade called «Ultimate Dry», combining miraDry^® with Morpheus8^® (microneedling with radiofrequency). Very fine needles penetrate the skin at defined depths and deliver radiofrequency energy at their tips, generating controlled thermal coagulation. This combined approach allows us to reach and ablate sweat glands at depths of up to 6 mm, including areas that miraDry^® alone may not sufficiently treat. The synergistic effect of Morpheus8^® enhances and prolongs the clinical outcome, often resulting in a more complete and longer-lasting reduction in local sweat production.