miraDry in London: results, cost, sessions and the risks

This guide is written by the team that runs miraDry at our clinic in the Harley Street medical district and reviewed by our clinician. It gives you the trial results with their sources, who the treatment suits, what a session is like, how we price it, the risks we go through with you, and a straight answer on one session or two.

What miraDry is

miraDry is a device made by miraDry, Inc. of San Jose, California. A handpiece is placed on the underarm skin, draws the skin up by vacuum against a cooled plate, and delivers a few seconds of microwave energy at 5.8 GHz. Water-rich tissue absorbs microwaves and fat absorbs little, so the energy is concentrated at the depth where the sweat glands sit, while the surface is protected by the cooling. The glands are heated enough to stop working. The manufacturer says they do not grow back, and a tissue sample from one patient 105 days after treatment showed no sweat glands in the treated skin.

The treatment is for the underarms only. The device's label says plainly that it must not be used for sweating of other body areas or for generalised sweating, and the manufacturer's own wording outside the US describes its use as primary axillary hyperhidrosis in adults. Hands, feet, face, back and chest are not miraDry areas.

The manufacturer puts the underarms at about 2% of the body's two to four million sweat glands and says treating them does not change how you cool down. In the trials, sweating elsewhere increased in a small number of people; we come back to that below.

Does miraDry work?

Yes, for most people. Here is where each figure comes from; the two main studies were funded by the manufacturer.

• The "82%". In the study behind the figure (Hong, 2012), 31 adults had one to three sessions and were followed for a year. Weighed sweat fell by 81.7% to 83.1% from baseline at every visit, and 90% of them rated their sweating as tolerable or unnoticeable at twelve months. It was a single-group study; the comparison with a sham comes from the next trial.
• The sham-controlled trial. In the pivotal trial (Glaser, 2012), 120 adults with severe underarm sweating were randomised to the real treatment or a sham. At 30 days, 89% of the treated group rated their sweating tolerable or unnoticeable against 54% of the sham group, and the treated group held at 74% at three months and 69% at a year. The trial used an earlier version of the device.
• Longer follow-up. A telephone survey of 18 patients about three years after treatment reported a mean sweat reduction of 61% to 70%, and in a Swedish series of 103 patients, about half of whom answered, the severity score was still improved at three years.
• Odour. In the 31-patient study, the share of people who said their odour was not noticeable rose from 13% before treatment to 61% to 74% afterwards. The US label says miraDry "may reduce underarm odor". A Copenhagen trial that treated one underarm with miraDry and the other with a treatment that has to be repeated every few months found the odour reduction lasted a year only on the miraDry side.
• Hair. In the US the device is also cleared to reduce underarm hair, with a 75% average reduction in hair count at a year in a 56-person study of skin types I to IV submitted to the US regulator. In the UK the manufacturer's stated use is sweat only, so we treat hair loss as a side effect you may welcome rather than a promise.

So the realistic picture is a large reduction in underarm sweat for most people after one or two sessions, three for some, measured in the trials for a year and in small follow-ups for three; a minority respond only partly, and in our experience a further session is the usual answer, agreed at your review.

What miraDry does well:

• Primary underarm hyperhidrosis that has beaten antiperspirants, including clinical-strength aluminium chloride.
• People who want to stop repeating a treatment every few months: in the Copenhagen trial, miraDry and the repeat treatment were equal on weighed sweat at a year, and 76% of patients preferred miraDry.
• Underarm odour, in the US label's wording above.

What miraDry does not do:

• It does not treat hands, feet, face, back or chest, and it is not for whole-body sweating.
• It does not treat secondary hyperhidrosis, where sweating is caused by another condition or a medicine. The clinician checks for a medical cause at your free consultation and refers you to your GP if another condition may be behind the sweating.
• It is not studied in people under 18; every trial enrolled adults.

Who miraDry suits, and who it does not

The treatment is for adults whose underarm sweating is primary, meaning it has no medical cause, and troublesome. Doctors grade it on a four-point scale: 1 is never noticeable, 2 is tolerable but sometimes interferes, 3 is barely tolerable and often interferes, 4 is intolerable and always interferes. NICE defines severe as 3 or 4, and that is who the trials enrolled. If antiperspirants have failed and your sweating is a 3 or a 4, you are the kind of patient the evidence covers.

The manufacturer's contraindications, from its 2024 user manual, are three:

• A pacemaker or any other implanted electronic device.
• Needing supplemental oxygen.
• A known intolerance of local anaesthetic, or of anything in the anaesthetic solution.

The manual also discourages treatment in pregnancy (it has not been tested), and in anyone who has had surgery in the underarm, including lymph node removal, a breast implant placed through the armpit, or previous sweat surgery. It asks for specialist advice before treating anyone with a metal implant, caution with people who are immunocompromised or heal poorly, and notes that eczema or psoriasis in the area, a high body weight and deep skin folds make treatment harder. Very thin people with little fat in the underarm are at higher risk of nerve injury, and we discuss energy settings and whether to treat at all with them.

If you are weighing miraDry against a treatment you repeat every few months, the clinician compares the two with you at your free consultation.

What a session is like, step by step

1. Consultation. The clinician asks about your sweating, what you have tried, your medicines and your health, and checks that the cause is primary. You get a plan and a price in writing. Consultations and follow-up reviews are free.
2. Preparation. Shave four to six days before, so a little regrowth shows where the hair grows, and skip deodorant the day before. Wear a loose top with wide armholes. Come with time to spare: the procedure itself takes about an hour.
3. Marking. A template is pressed onto each underarm to transfer a grid of marks; the manufacturer calls it a temporary tattoo, and in our experience it washes off over a few days.
4. Anaesthetic. Local anaesthetic is given with a needle across a grid on each underarm. This is the part you feel most: the manufacturer's manual says the numbing will likely cause discomfort, and the technique has moved to larger volumes of a more dilute solution, which NICE noted was intended to lower the chance of nerve injury. The treatment starts at least ten minutes after the numbing.
5. The treatment. The handpiece is placed on each square of the grid in turn. Each cycle draws the skin up by suction, delivers the energy for a few seconds and cools the skin before releasing. You feel pressure and warmth; one underarm takes up to about twenty minutes. The manufacturer recommends its lowest energy setting for a first session.
6. After. Ice packs wrapped in a towel go straight on, and you go home with instructions. In our experience most people go back to work the same or the next day.

One session or two, when you see the result, how long it lasts

At your consultation we tell you whether to budget for one session or two, and we review the result at three months, with a sweat test if you want one, before anyone books a second. A second session is not a failure of the first; NICE and the manufacturer both describe it as the route to the best result.

What miraDry costs in London

miraDry is priced per session, and a second session, if you need one, is usually charged again or offered as a package. We price miraDry from a starting price per session and per course, confirmed in writing at your free consultation, and we price match any comparable written quote. Consultations and follow-up reviews are free whatever you decide.

Your written plan says whether to budget for one session or two, what a second session costs, and who gives the anaesthetic and holds the handpiece.

Results you can check

The two photographs on this page are the manufacturer's and are labelled as such. At your consultation the clinician shows you what our own patients have reported, with their consent, and explains the starch-iodine sweat test, which turns sweating skin dark and lets you see your own result at three months.

Our reviews are collected through review.clinic, where you can read them. As of October 2026 they stand at 4.9 out of 5 from 82 reviews, with 100% of reviewers saying the treatment was worth it.

miraDry compared with the alternatives

miraDry vs a repeat treatment. In the Copenhagen trial, each patient had miraDry on one underarm and a treatment that has to be repeated every few months on the other. The repeat treatment reduced weighed sweat more at six months, the two were equal at a year, and odour and hair reduction lasted only on the miraDry side; 76% of the patients preferred miraDry. The repeat treatment is reversible and needs repeating once to three times a year; miraDry is a course of one or two sessions, with the procedure risks listed below and local anaesthetic at each session.

miraDry vs surgery. Surgery is the last step in the NICE pathway. Endoscopic thoracic sympathectomy, an operation on the nerve chain in the chest, is used for hand and face sweating, and one NHS trust leaflet quotes sweating elsewhere in up to 75 in 100 patients after palmar surgery, severe in 1 in 100. For the underarms, a systematic review found that microwave treatment did better than surgical suction-curettage of the glands in the short term, and that both outlasted the repeat treatment.

miraDry vs antiperspirants. Strong antiperspirants with aluminium chloride hexahydrate are NICE's first-line care, and miraDry is for the people they have not helped; if you are unsure whether you have tried the right one, the clinician advises at your free consultation.

Side effects and risks

Expect these, from the manufacturer's label: swelling or tightness, tenderness, redness and bruising from the suction and the anaesthetic, bumps under the skin, and altered sensation or tingling in the underarm and sometimes the upper arm. The label says most last a few days to a few weeks, and that the bumps, the tingling and a tight banding feeling in the underarm can last several months. In the 31-patient study, 71% had palpable lumps for a median of 41 days, 65% had altered sensation in the underarm for a median of 37 days, 90% had swelling for days to a week, and 26% lost some underarm hair. In the pivotal trial 10% had altered sensation in the upper arm skin for about two months, 5% had blisters, burns or ulcers lasting about a month, and 3% had lumps.

Less common, from the label: swelling spreading to the arm or torso, darkening of the skin, shoulder or arm soreness from lying still, a numb arm from the anaesthetic for under a day, and shakiness from the anaesthetic solution.

Rare, from the label and the case reports: altered sweating elsewhere on the body (2 of 81 in the pivotal trial), small blisters or ulcers, altered sensation or weakness in the forearm or fingers that can last months, infection or abscess, burns, and nerve injury. Two published case reports of nerve injury involved a thin 19-year-old, whose arm nerve recovered almost fully over a year, and a 49-year-old with a low body weight, whose arm nerve injury was still severe eight months later. Their authors advise low energy and caution in thin patients, and we discuss energy settings, and whether to treat at all, with anyone of a very thin build. NICE's 2017 guidance said patients should be informed about the possibility of nerve damage during consent, and we do that in writing.

NICE also noted in 2017 that the US regulator's adverse event database holds reports of nerve damage, infections, abscesses, burns and tissue death after this procedure. They are individual reports, not rates, and the clinician goes through every risk on the label with you before you consent.

Is miraDry available on the NHS?

Not usually. The NHS hyperhidrosis page does not mention it; the British Association of Dermatologists' 2018 patient leaflet says it is "not usually available as an NHS treatment in the UK". NICE's guidance on the procedure, published in December 2017, described the evidence at the time as limited in quantity and quality and asks for special arrangements for clinical governance, consent and audit or research. In practice it is a private treatment, and you can book a free consultation with us directly, without a GP referral.

What the NHS does offer, in NICE's order: lifestyle measures and strong antiperspirants; then iontophoresis or other specialist treatments; and surgery if those fail. If antiperspirants have not worked for you, book a free consultation: the clinician checks the cause of your sweating, refers you to your GP if another condition may be behind it, and tells you whether miraDry suits you.

How to choose a miraDry clinic

• Ask who gives the anaesthetic and who holds the handpiece. Ours are clinicians in a doctor-led team, and this guide is reviewed by Dr Marie Duggan, GMC 7488383.
• Ask what the price covers, in writing: one session or two, the anaesthetic, the reviews, and what a second session costs.
• Ask about the exclusions before you sign. Pacemaker or implants, oxygen, anaesthetic intolerance, pregnancy, previous underarm surgery, a very thin build.
• Ask which areas they treat. The label covers the underarms only.
• Ask for the source of any figure. Every percentage in this guide names its source.
• Check the reviews, and where they come from. Ours are on review.clinic.

Aftercare

Ice packs wrapped in a towel on the treated skin for the rest of the day and as needed over the next few days, and an ordinary anti-inflammatory painkiller if you need one. Keep the area clean with water and a gentle soap, and skip shaving, deodorant and antiperspirant for a few days; when you go back to them, open a new product rather than one you used before. Loose tops while the area is tender. No vigorous exercise for about three days, on the manufacturer's advice. Expect lumps and some numbness to outlast the swelling by weeks, and tell us if you have pain that needs more than a shop-bought painkiller, a spreading redness, a blister, or weakness or numbness in the forearm or fingers, which we want to see promptly rather than at the three-month review.

Frequently asked questions