Hyperhidrosis Treatment Options – Genius and Botox/Dysport
Dr. Weiner’s publication on treating hyperhidrosis using RFM: https://jddonline.com/articles/dermatology/S1545961618P0745X/1
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 is they are effective for only the less severe suffers and are temporary in nature. Botox is highly effective, but its duration is about 6 months and it is fairly costly at $1200-1500 per treatment.
More permanent measures include surgery, Miradry, and the newest treatment, Genius – RFM. There are 2 types of surgery available. The easier of the 2 is entering the axilla with either a laser or liposuction 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.
Genius brings a whole new prospective to the hyperhidrosis treatment paradigm. Genius can treat all areas of hyperhidrosis (except for the hands and feet with current protocols) with minimal risk. The heat from the Genius – 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 eradication 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 days.
The advantages Genius over Miradry are:
- Pain is much less. There is no need for blocks with Genius and there is no pain afterwards.
- Swelling is also much less. Most Genius clients have no change to their social activities or workout regime.
- 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.
- There is no hair loss. One of the side effects of Miradry is hair loss. For a male patient, this isn’t always desirable.
- Genius can be used in areas which the Miradry can’t be applied. Body and facial hyperhidrosis can be easily treated with the Genius but not the Miradry.
Botox for palmer hyperhidrosis is a quick and highly effective treatment to reduce the sweating. Dr. Weiner has popularized a technique where a cooling device – Artek is used to numb the hands during injection to minimize the discomfort. Each hand requires 40-50 small injections. Results take about a week to kick in and last 4-6 months.
When using Botox for axilla hyperhidrosis, Dr. Weiner uses a multi-needle injection device to make the entire treatment for one side take less than 1 minute. The results are highly effective and last 4-6 months.
Dr. Weiner has been treating facial and scalp hyperhidrosis with the Genius/Infini for several years. The patients describe about 40% improvement with one treatment and about 60% improvement after 2. There are no other long-term treatment options available for this malady. Results should be long lasting.
To summarize, for a low cost, low risk, well tolerated permanent treatment for hyperhidrosis, the Genius seems to be the obvious choice for those who can’t be controlled with topicals. (Miradry is not offered at The Aesthetic Clinique due to the reasons stated above.) Botox/Dysport is available to treat hands, feet, and other areas when desired.