Hyperhidrosis, excessive sweating, affects about 3% of the US population, which is about 10 million people. There are many areas affected by this disease, with the most common being the axilla, or underarm. Less common areas are: Face, body, hands, and feet. There are significant psychosocial implications of hyperhidrosis which can lead to isolation, depression, and lost job opportunities.

Measures recommended to try prior to initiating more aggressive measures are: Prescription grade antiperspirants, ionophoresis, or oral anticholinergic drugs. The downside to these measures are they are effective for only the lesser forms, and are temporary in nature. Botox is highly effective, but it’s duration is about 6 months and it is fairly costly, $1200-1500 per treatment.

More permanent measures include surgery, Miradry, and the newest treatment, Infini. There are 2 types of surgery available. The easier of the 2 is going into the axilla with either a laser or liposuction, after it is fully anesthetized, and destroying the sweat glands with heat or removing them. The other type of surgery enters the chest cavity and is called endoscopic thoracic sympathectomy (ETS). These 2 procedures are fairly invasive and have several risks. The Miradry, is a microwave device that is attached to the underarm after it has been injected with lidocaine. The treatment then consists of heating the area for several minutes which ultimately causes destruction of the sweat glands. It is usually repeated a second time. Result are long lasting and fairly consistent. Typical costs for Miradry are $3000 for the 2 sessions. One other consideration is that (except for Botox) these treatments are only effective for axillary hyperhidrosis.

Infini brings a whole new prospective to the hyperhidrosis treatment paradigm. Infini can treat all areas of hyperhidrosis (except for the hands and feet with current protocols) with minimal risk. The heat from the Infini – High Intensity Focused Radiofrequency (HIFR) is placed at the level of the sweat glands. These glands reside at the deep dermal layer or upper subcutaneous level. Using just topical anesthesia, the procedure can be performed with minimal discomfort in about 15 minutes for both axilla. There is no downtime or activity restrictions. It can be performed in all skin types. Areas of the face and body can be treated safely as well. The destruction of the sweat glands (apocrine and eccrine glands) is nonspecific, so there is not total erradication of the sweat. It is estimated by clients that they get 50 – 75% improvement in their sweat in one treatment. Results will be permanent because once the glands are destroyed, they don’t grow back. Most people are happy after only one treatment, but for further improvements, 2 or 3 total treatments can be performed. Results are seen in a few as 7 days.

The advantages of Infini over Miradry are:

  1. Pain is much less. There is no need for blocks with Infini and there is no pain afterwards.
  2. Swelling is also much less. Most Infini clients have no change to their social activities or workout regime.
  3. Cost is less. The cost for Infini treatment for a permanent solution is about the same as one treatment with Botox (6 months duration). Miradry is usually $3000 for 2 treatments. The Aesthetic Clinique charges $500 per treatment.
  4. There is no hair loss. One of the side effects of Miradry is hair loss. For a male patient, this isn’t always desirable.
  5. Infini can be used in areas which the Miradry can’t be applied. Body and facial hyperhidrosis can easily treated with the Infini but not the Miradry.

To summize, for a low cost, low risk, well tolerated permanent treatment for hyperhidrosis, the Infini seems to be the obvious choice for those who can’t be controlled with topical or oral medications.

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